MEDICARE: DR. CHIKEZIE CHIDIEBERE AMADI M.D.

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	207RI0011X	Interventional Cardiology Physician	036173394	IL
2	207RI0011X	Interventional Cardiology Physician	M9797	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487616918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIKEZIE CHIDIEBERE AMADI M.D.

Provider Business Mailing Address
First Line	:	1508 N ZARAGOZA RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-8034
Country	:	US
Telephone Number	:	915-373-9066
Fax Number	:	915-298-5430

Provider Business Practice Location Address
First Line	:	1508 N ZARAGOZA RD STE ABCD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-8034
Country	:	US
Telephone Number	:	915-373-9066
Fax Number	:	915-298-5430

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

Provider Enumeration Date	:	04/02/2006
Last Update Date	:	09/18/2025

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