Provider Demographics
NPI:1639489628
Name:OBI-OFODILE, DANIEL CHINWEUBA (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHINWEUBA
Last Name:OBI-OFODILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11901 SHADOW CREEK PKWY STE 111
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7346
Mailing Address - Country:US
Mailing Address - Phone:281-760-1971
Mailing Address - Fax:888-257-3780
Practice Address - Street 1:11901 SHADOW CREEK PKWY STE 111
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7346
Practice Address - Country:US
Practice Address - Phone:281-760-1971
Practice Address - Fax:888-257-3780
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA65248207Q00000X
TXP7524208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist