Provider Demographics
NPI:1396972659
Name:ABANONU, CHINEMEREM FRED (MD)
Entity type:Individual
Prefix:
First Name:CHINEMEREM
Middle Name:FRED
Last Name:ABANONU
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 1:18400 KATY FWY
Mailing Address - Street 2:MOB 1, SUITE 670
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77094
Mailing Address - Country:US
Mailing Address - Phone:832-522-8521
Mailing Address - Fax:832-522-8624
Practice Address - Street 1:18400 KATY FWY
Practice Address - Street 2:MEDICAL OFFICE BUILDING 1, SUITE 670
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77094
Practice Address - Country:US
Practice Address - Phone:832-522-8521
Practice Address - Fax:832-522-8624
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV15981207RH0003X
TXS8945207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1396972659Medicaid
NVPENDINGMedicare PIN