MEDICARE: CYNTHIA CHIDIMMA ONYEWUCHE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1130011	TX

General Provider Information

NPI Number	:	1184510786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA CHIDIMMA ONYEWUCHE

Provider Business Mailing Address
First Line	:	2031 JOHN WEST RD STE 107
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-4904
Country	:	US
Telephone Number	:	573-808-6695
Fax Number	:

Provider Business Practice Location Address
First Line	:	2031 JOHN WEST RD STE 107
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-4904
Country	:	US
Telephone Number	:	323-568-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	08/13/2025

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Directions to “ CYNTHIA CHIDIMMA ONYEWUCHE ” Practice Location

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