Provider Demographics
NPI:1366022626
Name:CHIKE, OBIORA JUNIOR
Entity Type:Individual
Prefix:
First Name:OBIORA
Middle Name:JUNIOR
Last Name:CHIKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4644 SATURN RD APT 2003
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-6239
Mailing Address - Country:US
Mailing Address - Phone:469-267-5911
Mailing Address - Fax:
Practice Address - Street 1:4644 SATURN RD APT 2003
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-6239
Practice Address - Country:US
Practice Address - Phone:469-267-5911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)