MEDICARE: DANIEL CHINWEUBA OBI-OFODILE 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	207Q00000X	Family Medicine Physician	65248	GA
2	208M00000X	Hospitalist Physician	P7524	TX
3	207Q00000X	Family Medicine Physician	P7524	TX

General Provider Information

NPI Number	:	1639489628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL CHINWEUBA OBI-OFODILE M.D

Provider Business Mailing Address
First Line	:	11901 SHADOW CREEK PKWY STE 111
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7346
Country	:	US
Telephone Number	:	281-760-1971
Fax Number	:	888-257-3780

Provider Business Practice Location Address
First Line	:	11901 SHADOW CREEK PKWY STE 111
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7346
Country	:	US
Telephone Number	:	281-760-1971
Fax Number	:	888-257-3780

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

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	02/13/2023

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Directions to “ DANIEL CHINWEUBA OBI-OFODILE M.D” Practice Location

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