Healthcare Provider Details

I. General information

NPI: 1629556295
Provider Name (Legal Business Name): MCFRANKLIN CHIGOZIE OGBONNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2018
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 ROSSVILLE DR
MIDLOTHIAN TX
76065-2418
US

IV. Provider business mailing address

214 ROSSVILLE DR
MIDLOTHIAN TX
76065-2418
US

V. Phone/Fax

Practice location:
  • Phone: 972-639-7776
  • Fax:
Mailing address:
  • Phone: 972-639-7776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number226388
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number824486
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP138498
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: