| Christie U Egbuchunam Md Pa | |
|
305 Regency Pkwy Suite 509 Mansfield TX 76063-3794 | |
| (817) 453-2323 | |
| (817) 453-2322 |
| Full Name | Christie U Egbuchunam Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 305 Regency Pkwy, Mansfield, Texas |
| Authorized Official Name and Position | Christie U Egbuchunam (PHYSICIAN/OWNER) |
| Authorized Official Contact | 8174532323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christie U Egbuchunam Md Pa 305 Regency Pkwy Suite 509 Mansfield TX 76063-3794 Ph: (817) 453-2323 | Christie U Egbuchunam Md Pa 305 Regency Pkwy Suite 509 Mansfield TX 76063-3794 Ph: (817) 453-2323 |
| NPI Number | 1770884603 |
|---|---|
| Provider Enumeration Date | 11/09/2010 |
| Last Update Date | 11/09/2010 |
| Medicare PECOS PAC ID | 3779764139 |
|---|---|
| Medicare Enrollment ID | O20110218000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770884603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M2313 (Texas) | Primary |
| Provider Name | Christie U Egbuchunam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053337709 PECOS PAC ID: 2668492935 Enrollment ID: I20051201000244 |
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