Provider Demographics
NPI:1306095021
Name:EKERUO, IJEOMA ANANABA (MD)
Entity type:Individual
Prefix:DR
First Name:IJEOMA
Middle Name:ANANABA
Last Name:EKERUO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:IJEOMA
Other - Middle Name:ELEWACHI
Other - Last Name:ANANABA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6431 FANNIN ST
Mailing Address - Street 2:MSB 1.246
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6590
Mailing Address - Fax:713-500-6556
Practice Address - Street 1:5550 KELLEY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026
Practice Address - Country:US
Practice Address - Phone:713-566-5225
Practice Address - Fax:713-566-5237
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9800207P00000X, 207R00000X, 207RC0000X, 208000000X, 207RC0001X
AZ75582207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198055902Medicaid
TX198055902Medicaid