Provider Demographics
NPI:1215179155
Name:MADUAKOR, OBIOMA NNENE (MD)
Entity Type:Individual
Prefix:DR
First Name:OBIOMA
Middle Name:NNENE
Last Name:MADUAKOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OBIOMA
Other - Middle Name:NNENE
Other - Last Name:NDUBIZU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11307 FM 1960 RD W STE 230
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4917
Mailing Address - Country:US
Mailing Address - Phone:713-697-2897
Mailing Address - Fax:713-574-1709
Practice Address - Street 1:11307 FM 1960 RD W STE 230
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4917
Practice Address - Country:US
Practice Address - Phone:713-697-2897
Practice Address - Fax:713-574-1709
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT5972207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL634650108Medicare PIN