Organization
CHINWENDU CHINWUBA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHINWENDU CHINWUBA (ADMINISTRATOR)
(832) 932-5545
Entity
Organization
Contact information
Practice address
2123 YORKTOWN CT S, LEAGUE CITY, TX 77573-5061
(832) 932-5545
Mailing address
2123 YORKTOWN CT S, LEAGUE CITY, TX 77573-5061
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456789
—
TX
Enumeration date
10/13/2011
Last updated
04/12/2013
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