Provider Demographics
NPI:1174782395
Name:ENEMUO, VALENTINE (MD)
Entity type:Individual
Prefix:DR
First Name:VALENTINE
Middle Name:
Last Name:ENEMUO
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 1:3533 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1721
Mailing Address - Country:US
Mailing Address - Phone:361-694-6128
Mailing Address - Fax:361-694-6955
Practice Address - Street 1:3533 S. ALAMEDA ST.
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-694-6128
Practice Address - Fax:361-694-6955
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.2024482080P0206X
TXN30222080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07729201Medicaid
TX205844805Medicaid
MS07729201Medicaid
TX205844801Medicaid
LA4N376F669Medicare PIN