ODIAKA MARK ANOMBEM MD
NPI 1902654759
Student in an Organized Health Care Education/Training Program in Tyler, TX

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since May 07, 2024PECOS Enrolled

11937 US HIGHWAY 271, TYLER, TX 75708(903) 877-7200 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Odiaka Mark Anombem Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ODIAKA MARK ANOMBEM MD (NPI 1902654759) is an individual student in an organized health care education/training program in Tyler, Texas and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902654759

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameODIAKA MARK ANOMBEMCredential: MD

Location Address11937 US HIGHWAY 271Tyler, TX 75708-3154

Mailing Address11937 Us Highway 271Tyler, TX 75708-3154 · (903) 877-7200

Phone(903) 877-7200

Sole ProprietorNo

Enumeration DateMay 7, 2024

NPPES CertifiedMay 7, 2024

✔ NPI 1902654759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

11937 US HIGHWAY 271, Tyler, TX 75708

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Odiaka Mark Anombem Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.