Provider Demographics
NPI:1740634997
Name:CHIDI, REGINA ADDO (MD)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:ADDO
Last Name:CHIDI
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 1:27800 NORTHWEST FWY STE 4201
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5302
Mailing Address - Country:US
Mailing Address - Phone:346-231-4628
Mailing Address - Fax:
Practice Address - Street 1:27800 NORTHWEST FWY STE 4201
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5302
Practice Address - Country:US
Practice Address - Phone:346-231-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA79378207Q00000X
390200000X
TXU1877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program