Healthcare Provider Details

I. General information

NPI: 1992268320
Provider Name (Legal Business Name): KOYENUM CHINONSO OBI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27126 NORTHWEST FWY STE 300
CYPRESS TX
77433-4932
US

IV. Provider business mailing address

1702 FM 1960 BYPASS RD E
HUMBLE TX
77338-3916
US

V. Phone/Fax

Practice location:
  • Phone: 281-446-7173
  • Fax:
Mailing address:
  • Phone: 281-446-7173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number330819
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberV7978
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: