Provider Demographics
NPI:1063744886
Name:NWACHUKWU, NNEOMA EUCHARIA (OD)
Entity type:Individual
Prefix:DR
First Name:NNEOMA
Middle Name:EUCHARIA
Last Name:NWACHUKWU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2601 PRESTON RD
Mailing Address - Street 2:SUITE #2124
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9468
Mailing Address - Country:US
Mailing Address - Phone:972-335-9529
Mailing Address - Fax:972-377-0648
Practice Address - Street 1:120 TOWN PL
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TX
Practice Address - Zip Code:75069-1822
Practice Address - Country:US
Practice Address - Phone:972-335-9529
Practice Address - Fax:972-377-0648
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7386TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB113994Medicare PIN