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Individual

IGHO C OLOBIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
541 W MAIN ST STE 110, LEWISVILLE, TX 75057
(469) 702-6633
(469) 702-6636
Mailing address
541 W MAIN ST STE 110, LEWISVILLE, TX 75057-3628
(469) 702-6633
(469) 702-6636

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K4178
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
040592001
TX
05
040592007
TX
Enumeration date
02/15/2006
Last updated
07/22/2019
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