Individual
CHIOMA J MGBOKWERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13800 EASTLAKE DR, SUITE400, HORIZON CITY, TX 79928-7297
(915) 577-1134
(915) 577-1136
Mailing address
13800 EASTLAKE DR, SUITE 400, HORIZON CITY, TX 79928-7297
(915) 577-1134
(915) 577-1136
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
P0856
TX
207R00000X
Internal Medicine Physician
Primary
P0856
TX
208000000X
Pediatrics Physician
P0856
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299693603
—
TX
01
—
P01279531
MEDICARE RAILROAD
TX
Enumeration date
09/08/2011
Last updated
03/14/2023
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