Provider Demographics
NPI:1245573252
Name:OBIAGWU, CHUKWUDI LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUKWUDI
Middle Name:LAWRENCE
Last Name:OBIAGWU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-5620
Mailing Address - Country:US
Mailing Address - Phone:940-263-3003
Mailing Address - Fax:940-263-3009
Practice Address - Street 1:1600 BROOK AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-5620
Practice Address - Country:US
Practice Address - Phone:940-263-3003
Practice Address - Fax:940-263-3009
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4832207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology