Provider Demographics
NPI:1336404748
Name:ECHENDU, CHISAROKA WOBIARERI (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHISAROKA
Middle Name:WOBIARERI
Last Name:ECHENDU
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1802
Mailing Address - Country:US
Mailing Address - Phone:409-981-5510
Mailing Address - Fax:409-981-5511
Practice Address - Street 1:310 N 11TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1802
Practice Address - Country:US
Practice Address - Phone:409-981-5510
Practice Address - Fax:409-981-5511
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ93392085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology