Provider Demographics
NPI:1306881032
Name:OSONDU, OBIH CHRIS (BS)
Entity type:Individual
Prefix:MR
First Name:OBIH
Middle Name:CHRIS
Last Name:OSONDU
Suffix:
Gender:M
Credentials:BS
Other - Prefix:MR
Other - First Name:OBIH
Other - Middle Name:CHRIS
Other - Last Name:OSONDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ADMINISTRATOR
Mailing Address - Street 1:5708 ROCKPORT LN
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76137-2123
Mailing Address - Country:US
Mailing Address - Phone:817-673-1030
Mailing Address - Fax:817-268-2772
Practice Address - Street 1:5708 ROCKPORT LN
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76137-2123
Practice Address - Country:US
Practice Address - Phone:817-673-1030
Practice Address - Fax:817-268-2772
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008235374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457819Medicare ID - Type UnspecifiedHOME HEALTH SERVICES