Healthcare Provider Details

I. General information

NPI: 1679098313
Provider Name (Legal Business Name): CHIOMA MUOGHALU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6905 DAVIS BLVD STE 200
NORTH RICHLAND HILLS TX
76182-4011
US

IV. Provider business mailing address

6905 DAVIS BLVD STE 200
NORTH RICHLAND HILLS TX
76182-4011
US

V. Phone/Fax

Practice location:
  • Phone: 817-922-0800
  • Fax: 817-922-0805
Mailing address:
  • Phone: 575-769-7577
  • Fax: 817-922-0805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV6069
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: