PROSPERITY EZEANUNA MD NPI 1235275900

NPI Information

  • NPI: 1235275900
  • Provider Name: PROSPERITY EZEANUNA, MD
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1673 BRIARCREST DR STE 100B
    BRYAN, TX
    ZIP 77802
  • Phone: (979) 985-5339

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NPI Details

Prosperity Ezeanuna, MD is a nephrology internal medicine in Bryan, TX with 30 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Prosperity Ezeanuna, MD NPI is 1235275900. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1673 BRIARCREST DR STE 100B
BRYAN, TX
ZIP 77802-756
Phone: (979) 985-5339
Fax: (979) 705-3505

The NPI 1235275900 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dialysis services, 4 or more physician visits per month (20 years or older) (HCPCS:90960)

The enumeration date for this NPI number is 1/30/2007 and was last updated on 3/2/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyN4405TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
130207833MEDICAIDNEW HAMPSHIRE
2532956099MEDICAIDMAINE
3000677201MEDICARE PINMAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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