# CHISOM MEDICAL GROUP LLC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CY-FAIR MEDICAL SUPPLY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639189954
- **Authorized official:** SYLVESTER CHUKWUEMEKA OGUH (PRESIDENT/CEO)
- **Authorized official phone:** (601) 454-3878

## Contact information

- **Practice address:** 10511 JONES RD, E, HOUSTON, TX 77065-4291
- **Practice address phone:** (281) 469-2300
- **Practice address fax:** (281) 469-2315
- **Mailing address:** 10511 JONES RD, E, HOUSTON, TX 77065-4291
- **Mailing address phone:** (281) 469-2300
- **Mailing address fax:** (281) 469-2315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0089455 | TX | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 08/22/2020