Active NPI
Chukwuemeka Nwankire Etufugh, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Richardson, TX
National Provider Identifier
1063622850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- N6285
- Practice address
- 1001 Buckingham Rd Ste 200
Richardson, TX 75081 - Phone
- (469) 776-8990
- Fax
- (469) 776-9069
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | BP10026179 | TX | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | N6285 | TX | Primary |
Addresses
Primary practice location
1001 Buckingham Rd Ste 200
Richardson, TX 75081
Mailing address
2524 Merlin Dr
Lewisville, TX 75056-5702
Phone (646) 594-6792
Other practice location 1
3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-2251
Other practice location 2
7777 Forest Ln Ste C350
Dallas, TX 75230-2544
Phone (972) 598-6336
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N6285 | TX | MD | Anatomic Pathology & Clinical Pathology Physician |
| BP10026179 | TX | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527724800000",
"number": "1063622850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2524 MERLIN DR",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750565702",
"telephone_number": "646-594-6792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BUCKINGHAM RD STE 200",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "75081",
"telephone_number": "469-776-8990",
"fax_number": "469-776-9069"
}
],
"practiceLocations": [
{
"address_1": "3500 Gaston Ave",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752462017",
"country_code": "US",
"telephone_number": "214-820-2251",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7777 Forest Ln Ste C350",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752302544",
"country_code": "US",
"telephone_number": "972-598-6336",
"fax_number": "972-598-6355",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ETUFUGH",
"first_name": "CHUKWUEMEKA",
"middle_name": "NWANKIRE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2018-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "BP10026179",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "TX",
"license": "N6285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.