Provider Demographics
NPI:1326643115
Name:CHINEDO, LILIAN NGOZI
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:NGOZI
Last Name:CHINEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7419 COLBY RUN CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-8019
Mailing Address - Country:US
Mailing Address - Phone:713-540-6120
Mailing Address - Fax:
Practice Address - Street 1:7419 COLBY RUN CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8019
Practice Address - Country:US
Practice Address - Phone:713-540-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020478363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner