Individual
DR. OBINNA CHARLES UKABAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R0970
TX
207RG0100X
Gastroenterology Physician
Primary
R0970
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379300201
—
TX
01
—
379300202
CSHCN
TX
05
—
379300206
—
TX
Enumeration date
06/28/2011
Last updated
12/09/2024
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