Provider Demographics
NPI:1992268320
Name:OBI, KOYENUM CHINONSO (MD)
Entity type:Individual
Prefix:
First Name:KOYENUM
Middle Name:CHINONSO
Last Name:OBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 FM 1960 BYPASS RD E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3916
Mailing Address - Country:US
Mailing Address - Phone:281-446-7173
Mailing Address - Fax:
Practice Address - Street 1:27126 NORTHWEST FWY STE 300
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-4932
Practice Address - Country:US
Practice Address - Phone:281-446-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330819207R00000X
390200000X
TXV7978207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program