Provider Demographics
NPI:1225044910
Name:ACHO, ONYEBUCHI SONNY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ONYEBUCHI
Middle Name:SONNY
Last Name:ACHO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 HILLCREST RD
Mailing Address - Street 2:SUITE 254
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2033
Mailing Address - Country:US
Mailing Address - Phone:972-726-6103
Mailing Address - Fax:972-726-0344
Practice Address - Street 1:12700 HILLCREST RD
Practice Address - Street 2:SUITE 254
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2033
Practice Address - Country:US
Practice Address - Phone:972-726-6103
Practice Address - Fax:972-726-0344
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC 10234101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4514013OtherAETNA PROVIDER ID
TX2001LCOtherBC/BS