Individual
CHARLES CHIBUNDU MBONU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2604 ST. MICHAEL DRIVE, SUITE 310, TEXARKANA, TX 75503
(903) 614-5001
(903) 614-5077
Mailing address
P.O. BOX 7707, TEXARKANA, TX 75505
(903) 614-5001
(903) 614-5077
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N3171
TX
207RI0200X
Infectious Disease Physician
Primary
N3171
TX
Other
Enumeration date
03/14/2006
Last updated
12/09/2014
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