Individual
CHRISTIE U. EGBUCHUNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
305 REGENCY PKWY, SUITE 509, MANSFIELD, TX 76063-3794
(817) 453-2323
(817) 453-2322
Mailing address
305 REGENCY PKWY, SUITE 509, MANSFIELD, TX 76063-3794
(817) 453-2323
(817) 453-2322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M2313
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179924901
—
TX
05
—
179924902
—
TX
01
—
8K4033
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/14/2006
Last updated
01/26/2011
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