Provider Demographics
NPI:1598719338
Name:NDUBUEZE, CHINONYEREM (MD)
Entity Type:Individual
Prefix:
First Name:CHINONYEREM
Middle Name:
Last Name:NDUBUEZE
Suffix:
Gender:F
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:PO BOX 58406
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8406
Mailing Address - Country:US
Mailing Address - Phone:281-724-7341
Mailing Address - Fax:281-724-1861
Practice Address - Street 1:500 N KOBAYASHI STE A
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4722
Practice Address - Country:US
Practice Address - Phone:281-724-7341
Practice Address - Fax:281-724-1861
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3036208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
H53432Medicare UPIN
TX8482N4Medicare PIN