Provider Demographics
NPI:1811197106
Name:OBI, CYNTHIA NGOZICHUKWUKA (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:NGOZICHUKWUKA
Last Name:OBI
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 1:24948 FM 1093 RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-3619
Mailing Address - Country:US
Mailing Address - Phone:281-347-2228
Mailing Address - Fax:
Practice Address - Street 1:24948 FM 1093 RD
Practice Address - Street 2:SUITE 205
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-3619
Practice Address - Country:US
Practice Address - Phone:281-347-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190805207P00000X
TXN6543207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1811197106OtherBCBS TX
1811197106OtherTRI CARE SOUTH
TX8CK062OtherBCBS TX
TX8CK062OtherBCBS TX