Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | R2431 | TX |
NPI | 1205008372 |
---|---|
Provider Name | Dr. Anaeze Chidiebele Offodile II |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2008 |
Last Update Date | 22/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
372365202 | CSHCN MEDICAID TPI (01) | TX |
373365201 | (05) | TX |