Provider Demographics
NPI:1154687960
Name:ONWUKA, EKENEDILICHUKWU AZUKA
Entity Type:Individual
Prefix:DR
First Name:EKENEDILICHUKWU
Middle Name:AZUKA
Last Name:ONWUKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 OLD SPANISH TRL APT 2159
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1860
Mailing Address - Country:US
Mailing Address - Phone:219-201-6791
Mailing Address - Fax:
Practice Address - Street 1:6701 FANNIN ST STE 1210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2612
Practice Address - Country:US
Practice Address - Phone:219-201-6791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
TXS71132086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric SurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program