1447493531 NPI number — CONSTANCE ELOHOR ANANI M.D.

Table of content: CONSTANCE ELOHOR ANANI M.D. (NPI 1447493531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447493531 NPI number — CONSTANCE ELOHOR ANANI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANANI
Provider First Name:
CONSTANCE
Provider Middle Name:
ELOHOR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EJOVI
Provider Other First Name:
CONSTANCE
Provider Other Middle Name:
ELOHOR
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447493531
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1111 MEDICAL PLAZA DR
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
THE WOODLANDS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77380-3476
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-296-8788
Provider Business Mailing Address Fax Number:
281-465-4596

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1111 MEDICAL PLAZA DR
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
THE WOODLANDS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77380-3476
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-296-8788
Provider Business Practice Location Address Fax Number:
281-465-4596
Provider Enumeration Date:
04/20/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  Q6930 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 362797801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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