Provider Demographics
NPI:1689008179
Name:ANOZIE, EBERECHI (DO)
Entity type:Individual
Prefix:
First Name:EBERECHI
Middle Name:
Last Name:ANOZIE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 W INTERSTATE 20
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5838
Mailing Address - Country:US
Mailing Address - Phone:817-472-6555
Mailing Address - Fax:817-472-6562
Practice Address - Street 1:1540 W INTERSTATE 20
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5838
Practice Address - Country:US
Practice Address - Phone:817-472-6555
Practice Address - Fax:817-472-6562
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2106207Q00000X
NY267523-1207Q00000X
NY267523207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine