Provider Demographics
NPI:1093960718
Name:EFURIBE, CHINWE OYERONKE (MD)
Entity Type:Individual
Prefix:
First Name:CHINWE
Middle Name:OYERONKE
Last Name:EFURIBE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHINWE
Other - Middle Name:OYERONKE
Other - Last Name:UMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20617 FAIRLEAF ST
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2664
Mailing Address - Country:US
Mailing Address - Phone:860-983-6542
Mailing Address - Fax:
Practice Address - Street 1:14008 SHADOWGLEN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653-3406
Practice Address - Country:US
Practice Address - Phone:512-900-1780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047128208000000X
MN54916208000000X
TXQ53972080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine