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General NPI Number Information
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NPI Number | 1467469981
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Entity Type | Individual
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Provider Name | SAMUEL CHUKWUDI CHIDOKA PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11200 WESTHEIMER 953
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City | HOUSTON
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State | TX
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Zip | 77042
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Country | US
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Telephone | 713-243-8728
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Fax | 713-243-8759
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Provider Business Mailing Address
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Address Line | 3315 WESTWICK
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City | HOUSTON
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State | TX
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Zip | 77082
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Country | US
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Telephone | 281-770-1279
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Fax | 713-243-8759
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA03684
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License Number State | TX
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