Provider Demographics
NPI:1881911592
Name:ANYAOKU, JACINTA OGECHUKWUKA (MD)
Entity type:Individual
Prefix:DR
First Name:JACINTA
Middle Name:OGECHUKWUKA
Last Name:ANYAOKU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JACINTA
Other - Middle Name:OGECHUKWUKA
Other - Last Name:ODAFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:26622 COOK FIELD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2139
Mailing Address - Country:US
Mailing Address - Phone:281-394-4959
Mailing Address - Fax:281-392-8780
Practice Address - Street 1:26622 COOK FIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2139
Practice Address - Country:US
Practice Address - Phone:281-394-4959
Practice Address - Fax:281-392-8780
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC164500OtherRESIDENT TRAINING LICENSE
NCAC5385578-R638OtherDEA