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General NPI Number Information
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NPI Number | 1437109220
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Entity Type | Organization
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Legal Business Name | COMPLETE FAMILY PRACTICE & SPORTS MEDICINE, PA
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 1151 N BUCKNER BLVD SUITE 405
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City | DALLAS
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State | TX
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Zip | 75218-3426
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Country | US
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Telephone | 214-319-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 N BUCKNER BLVD SUITE 405
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City | DALLAS
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State | TX
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Zip | 75218-3426
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Country | US
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Telephone | 214-319-2900
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/PRESIDENT
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Name | DR. OBINNA U CHUKWUOCHA
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Credential | D.O.
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Telephone | 214-319-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State | TX
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