Active NPI
Noble Ezukanma M.D P.a
- Pulmonary Disease Physician
- Fort Worth, TX
National Provider Identifier
1235467804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- K8745
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K8745 | Other | TX | STATE LICENSE |
Other names 1
- Nobility Pulmonary Consultants
National Provider Directory
National Provider DirectoryNPI 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.