Healthcare Provider Details

I. General information

NPI: 1063388718
Provider Name (Legal Business Name): ADAORA CHUKWURAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13581 POND SPRINGS RD STE 120
AUSTIN TX
78729-4421
US

IV. Provider business mailing address

13010 RIDGELINE BLVD
CEDAR PARK TX
78613-1792
US

V. Phone/Fax

Practice location:
  • Phone: 512-612-2603
  • Fax:
Mailing address:
  • Phone: 512-920-8846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2844251
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-281704
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: