Organization Active NPI

Ezukanma Group of Companies Inc

  • Pulmonary Disease Physician
  • Fort Worth, TX
National Provider Identifier
1508069121
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
K8745 Issued in TX
Legal business name
EZUKANMA GROUP OF COMPANIES INC
Practice address
508 S Adams St
Suite 100
Fort Worth, TX 76104-2147
Phone
(817) 882-9901
Fax
(817) 882-8135
NPI assigned
Jun 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Noble Ezukanma, M.D.
Title
President
Phone
(817) 882-9901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X K8745 TX Primary

Addresses

Primary practice location

508 S Adams St
Suite 100
Fort Worth, TX 76104-2147

Mailing address

117 King Ranch CT
Fort Worth, TX 76108-9593
Phone (817) 882-9901

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1181433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508069121",
    "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",
            "telephone_number": "817-882-9901",
            "fax_number": "817-882-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S ADAMS ST",
            "address_2": "SUITE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042147",
            "telephone_number": "817-882-9901",
            "fax_number": "817-882-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZUKANMA GROUP OF COMPANIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EZUKANMA",
        "authorized_official_first_name": "NOBLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-882-9901",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "K8745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.