Provider Demographics
NPI:1447713813
Name:IGWE, JOSEPH-KEVIN (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH-KEVIN
Middle Name:
Last Name:IGWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSEPH-KELVIN
Other - Middle Name:
Other - Last Name:IGWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15210 NEWPORT BRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-1307
Mailing Address - Country:US
Mailing Address - Phone:832-439-8013
Mailing Address - Fax:
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-873-8890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA93738207R00000X
TXU4410207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine