Provider Demographics
NPI:1285977231
Name:OGBONNAYA-ODOR, CHINONYE CHIKA (MD)
Entity type:Individual
Prefix:
First Name:CHINONYE
Middle Name:CHIKA
Last Name:OGBONNAYA-ODOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 E BASSE RD STE 180-472
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1801
Mailing Address - Country:US
Mailing Address - Phone:210-941-8133
Mailing Address - Fax:614-412-9217
Practice Address - Street 1:999 E BASSE RD STE 180-472
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1801
Practice Address - Country:US
Practice Address - Phone:210-941-8133
Practice Address - Fax:614-412-9217
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2023-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5300207R00000X, 207RN0300X, 246ZN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZN0300XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology