Provider Demographics
NPI:1497524458
Name:NWADIKE, CHIAMAKA IMMACULETA
Entity Type:Individual
Prefix:
First Name:CHIAMAKA
Middle Name:IMMACULETA
Last Name:NWADIKE
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 1:2510 FOREST SIDE CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2474
Mailing Address - Country:US
Mailing Address - Phone:832-396-5002
Mailing Address - Fax:
Practice Address - Street 1:6901 BERTNER AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3901
Practice Address - Country:US
Practice Address - Phone:713-500-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX952145163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health