Organization Active NPI

Noble Ezukanma M.D P.a

  • Pulmonary Disease Physician
  • Fort Worth, TX
National Provider Identifier
1235467804
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
K8745 Issued in TX
Legal business name
NOBLE EZUKANMA M.D P.A
Practice address
117 King Ranch CT
Fort Worth, TX 76108-9593
Phone
(817) 300-1471
NPI assigned
Nov 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Noble U Ezuknama, M.D.
Title
Owner
Phone
(817) 300-1471

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X K8745 TX Primary

Addresses

Primary practice location

117 King Ranch CT
Fort Worth, TX 76108-9593

Mailing address

117 King Ranch CT
Fort Worth, TX 76108-9593

Other identifiers 1

IdentifierTypeStateIssuer
K8745OtherTXSTATE LICENSE

Other names 1

  • Nobility Pulmonary Consultants Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1235467804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 KING RANCH CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761089593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 KING RANCH CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761089593",
            "telephone_number": "817-300-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOBLE EZUKANMA M.D P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "EZUKNAMA",
        "authorized_official_first_name": "NOBLE",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-300-1471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "K8745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "K8745",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nobility Pulmonary Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.