Provider Demographics
NPI:1669787081
Name:CHIKE-OBI, CHUMA J (MD)
Entity type:Individual
Prefix:
First Name:CHUMA
Middle Name:J
Last Name:CHIKE-OBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E CESAR CHAVEZ ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-4577
Mailing Address - Country:US
Mailing Address - Phone:512-615-3280
Mailing Address - Fax:512-666-3763
Practice Address - Street 1:327 E CESAR CHAVEZ ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701
Practice Address - Country:US
Practice Address - Phone:512-615-3280
Practice Address - Fax:512-546-7956
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP48532086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP4853OtherSTATE LICENSE