Provider Demographics
NPI:1275802472
Name:ONONIWU, IKECHUKWU UCHENNA (PTA)
Entity Type:Individual
Prefix:
First Name:IKECHUKWU
Middle Name:UCHENNA
Last Name:ONONIWU
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 N CAMDEN PKWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-5209
Mailing Address - Country:US
Mailing Address - Phone:832-444-7918
Mailing Address - Fax:713-789-4616
Practice Address - Street 1:2530 N CAMDEN PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-5209
Practice Address - Country:US
Practice Address - Phone:832-444-7918
Practice Address - Fax:713-789-4616
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11214268171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor