Individual
CHINENYE OKECHUKWU MBACHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3551 ROGER BROOKE DR APT 300, FORT SAM HOUSTON, TX 78234-4517
(210) 916-4141
(713) 458-4229
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-4141
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP128887
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350970501
—
TX
01
—
8394UL
BCBS
TX
01
—
P01746196
RR MEDICARE
TX
Enumeration date
10/02/2015
Last updated
06/22/2024
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