MEDICARE: DR. KANENECHUKWU VIRGINIA UBESIE MD, MBA, FACS

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	2086S0127X	Trauma Surgery Physician	Q6716	TX
2	2086S0102X	Surgical Critical Care Physician	Q6716	TX
3	208600000X	Surgery Physician	Q6716	TX

General Provider Information

NPI Number	:	1205026333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KANENECHUKWU VIRGINIA UBESIE MD, MBA, FACS

Provider Business Mailing Address
First Line	:	8700 STONEBROOK PKWY UNIT 958
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-5804
Country	:	US
Telephone Number	:	972-850-6122
Fax Number	:

Provider Business Practice Location Address
First Line	:	4333 N JOSEY LN STE 101
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4620
Country	:	US
Telephone Number	:	972-850-6122
Fax Number	:

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

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	08/20/2025

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