1306881032 NPI number — MR. OBIH CHRIS OSONDU BS

Table of content: MR. OBIH CHRIS OSONDU BS (NPI 1306881032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306881032 NPI number — MR. OBIH CHRIS OSONDU BS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSONDU
Provider First Name:
OBIH
Provider Middle Name:
CHRIS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
BS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OSONDU
Provider Other First Name:
OBIH
Provider Other Middle Name:
CHRIS
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ADMINISTRATOR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306881032
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5708 ROCKPORT LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HALTOM CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76137-2123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-673-1030
Provider Business Mailing Address Fax Number:
817-268-2772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5708 ROCKPORT LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALTOM CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76137-2123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-673-1030
Provider Business Practice Location Address Fax Number:
817-268-2772
Provider Enumeration Date:
06/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 374U00000X , with the licence number:  008235 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)