Provider Demographics
NPI:1417769126
Name:IVANA MD PLLC
Entity type:Organization
Organization Name:IVANA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NWANYIEZE
Authorized Official - Middle Name:IVANA
Authorized Official - Last Name:AMAJOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-446-6973
Mailing Address - Street 1:4220 CARTWRIGHT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5308
Mailing Address - Country:US
Mailing Address - Phone:346-585-4077
Mailing Address - Fax:
Practice Address - Street 1:4220 CARTWRIGHT RD STE 201
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5308
Practice Address - Country:US
Practice Address - Phone:346-585-4077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty