Basic Information
| Provider Information | |||||||||
| NPI: | 1568805042 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NNAMEKA | ||||||||
| FirstName: | UJU | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 E 15TH ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787011930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123248355 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 E 15TH ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787011930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123248355 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2013 | ||||||||
| LastUpdateDate: | 11/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2016034310 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ETFH-005 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | R0627 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 2016034310 | MO | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208M00000X | R0627 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | BP10046409 | 01 | TX | BASIC POST GRADUATE TRAINING PERMIT | OTHER |