Provider Demographics
NPI:1881310969
Name:OBI, CHINAZO GENEVIVE
Entity type:Individual
Prefix:
First Name:CHINAZO
Middle Name:GENEVIVE
Last Name:OBI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CHINAZO
Other - Middle Name:GENEVIVE
Other - Last Name:ORGAZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5900 BALCONES DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4298
Mailing Address - Country:US
Mailing Address - Phone:405-684-7743
Mailing Address - Fax:
Practice Address - Street 1:4130 N LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-5209
Practice Address - Country:US
Practice Address - Phone:405-424-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1096936363LP0808X
NM71260363LP0808X
IAG172504363LP0808X
FLAPRN11023620363LP0808X
OK212999363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health