Provider Demographics
NPI:1215906979
Name:ISIGUZO, OBINNA GIFT (MD)
Entity type:Individual
Prefix:
First Name:OBINNA
Middle Name:GIFT
Last Name:ISIGUZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 W IH 10
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-2038
Mailing Address - Country:US
Mailing Address - Phone:210-692-8811
Mailing Address - Fax:210-477-9097
Practice Address - Street 1:6800 W IH 10
Practice Address - Street 2:SUITE 350
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-2038
Practice Address - Country:US
Practice Address - Phone:210-692-1414
Practice Address - Fax:210-477-9097
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6378207RC0000X
OH35-078159174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist