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Contact Information

PROSPERITY EZEANUNA, MD
2310 DE LEE STREET
SUITE 300
BRYAN, TX77802
 Phone: 979-485-4901
 Fax: 979-485-9402
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nephrology

207RN0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PROSPERITY EZEANUNA · (Male)

NPI # 1235275900
Status Active
Credentials MD
Entity Individual
Enumeration date 01/30/2007
Last updated 03/02/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • TX License # N4405
  • ME Medicaid 532956099
  • NH Medicaid 30207833
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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