MEDICARE: DR. CHINYERE NNENNA AWA M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	L7651	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669415279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHINYERE NNENNA AWA M.D

Provider Business Mailing Address
First Line	:	PO BOX 572506
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77257-2506
Country	:	US
Telephone Number	:	713-541-4442
Fax Number	:	713-541-4567

Provider Business Practice Location Address
First Line	:	6300 WESTPARK DR STE 212
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-7207
Country	:	US
Telephone Number	:	713-541-4442
Fax Number	:	713-541-4567

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	01/16/2020

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