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General NPI Number Information
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NPI Number | 1053591164
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Entity Type | Organization
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Legal Business Name | CHIJIOKE D. UKOHA MD PA
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 1800 N GALLOWAY AVE SUITE 100
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City | MESQUITE
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State | TX
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Zip | 75149-2299
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Country | US
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Telephone | 972-279-1700
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Fax | 972-279-1102
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Provider Business Mailing Address
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Address Line | 306 STONEMEADE WAY
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City | COPPELL
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State | TX
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Zip | 75019-2679
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Country | US
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Telephone | 972-279-1700
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Fax | 972-279-1102
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CHIJIOKE DAVID UKOHA
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Credential | MD
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Telephone | 972-279-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J8405
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License Number State | TX
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