Provider Demographics
NPI:1669727053
Name:ILOCHONWU, KINGSLEY (MD)
Entity type:Individual
Prefix:DR
First Name:KINGSLEY
Middle Name:
Last Name:ILOCHONWU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24003 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5897
Mailing Address - Country:US
Mailing Address - Phone:832-759-5360
Mailing Address - Fax:
Practice Address - Street 1:24003 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471
Practice Address - Country:US
Practice Address - Phone:832-759-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8681207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine