Provider Demographics
NPI:1821615659
Name:EKWEALOR, CHRISTOPHER CHIKE
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CHIKE
Last Name:EKWEALOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-4081
Mailing Address - Country:US
Mailing Address - Phone:832-850-8761
Mailing Address - Fax:281-437-6622
Practice Address - Street 1:1138 TURTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4081
Practice Address - Country:US
Practice Address - Phone:832-850-8761
Practice Address - Fax:281-437-6622
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-27
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251S00000XAgenciesCommunity/Behavioral Health