Provider Demographics
NPI:1316997455
Name:CHUKWUOCHA, OBINNA (DO)
Entity type:Individual
Prefix:DR
First Name:OBINNA
Middle Name:
Last Name:CHUKWUOCHA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 W PLANO PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4852
Mailing Address - Country:US
Mailing Address - Phone:972-818-8800
Mailing Address - Fax:
Practice Address - Street 1:5400 W PLANO PKWY
Practice Address - Street 2:SUITE 230
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4852
Practice Address - Country:US
Practice Address - Phone:972-818-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9145207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI17072Medicare UPIN
TX8F3125Medicare PIN