Provider Demographics
NPI:1619430469
Name:EKWEMALOR, CHUKWUDI CHRISTOPHER (PHD, MBA, MSN, APRN)
Entity Type:Individual
Prefix:DR
First Name:CHUKWUDI
Middle Name:CHRISTOPHER
Last Name:EKWEMALOR
Suffix:
Gender:M
Credentials:PHD, MBA, MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16910 MIDNIGHT SKY CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4744
Mailing Address - Country:US
Mailing Address - Phone:832-335-1866
Mailing Address - Fax:
Practice Address - Street 1:16910 MIDNIGHT SKY CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4744
Practice Address - Country:US
Practice Address - Phone:713-382-4659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141230363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health