Provider Demographics
NPI:1104489681
Name:UNEGBU, FORTUNE CHIMDINDU (MD)
Entity type:Individual
Prefix:DR
First Name:FORTUNE
Middle Name:CHIMDINDU
Last Name:UNEGBU
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:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-420-0186
Mailing Address - Fax:903-200-5107
Practice Address - Street 1:1361 HERO WAY STE 100
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-5579
Practice Address - Country:US
Practice Address - Phone:512-244-2273
Practice Address - Fax:512-862-4739
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV7092207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology