Provider Demographics
NPI:1275542664
Name:CHIRA, EBELE CHIDUM (MD)
Entity Type:Individual
Prefix:
First Name:EBELE
Middle Name:CHIDUM
Last Name:CHIRA
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 1:1055 CLARKSVILLE ST
Mailing Address - Street 2:STE 140
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-6097
Mailing Address - Country:US
Mailing Address - Phone:903-905-4610
Mailing Address - Fax:
Practice Address - Street 1:1055 CLARKSVILLE ST
Practice Address - Street 2:STE 140
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-6097
Practice Address - Country:US
Practice Address - Phone:903-905-4610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8174207RE0101X, 207RE0101X
NC2007-01002207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine