Individual provider Active NPI

Charles Chibundu Mbonu, MD

  • Infectious Disease Physician
  • Texarkana, TX
National Provider Identifier
1033187299
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
N3171 Issued in TX
Practice address
1002 Texas Blvd Ste 200
Texarkana, TX 75501-5133
Phone
(903) 310-4950
Fax
(903) 793-8350
NPI assigned
Mar 14, 2006
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N3171 TX
Infectious Disease Physician 207RI0200X N3171 TX Primary

Addresses

Primary practice location

1002 Texas Blvd Ste 200
Texarkana, TX 75501-5133

Mailing address

PO Box 7707
Texarkana, TX 75505-7707
Phone (903) 310-4950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090825000280 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 6204824741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Infectious Diseases, PLLCGroup PAC ID 3274687355, 2 clinicians

Practice addresses (Care Compare)

2604 Saint Michael Dr
Suite 310
Texarkana, TX 75503-2378
Phone (903) 614-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N3171TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Infectious Diseases, PLLC Infectious Disease CurrentSince Aug 1, 2009 Accepting new patients
Coastal Family Health Center Past Accepting new patients
Coastal Family Health Center, Inc Past Accepting new patients
Claudia R. Libertin MD LLC Infectious Disease Past Accepting new patients
C H Wilkinson Physician Network PastSince Aug 1, 2009 Accepting new patients

Locations

1002 Texas Blvd
Ste 200
Texarkana, TX 75501
Phone (903) 792-1404

2604 Saint Michael Dr
Ste 310
Texarkana, TX 75503
Phone (903) 614-5050

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1033187299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7707",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755057707",
            "telephone_number": "903-310-4950",
            "fax_number": "903-793-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD STE 200",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015133",
            "telephone_number": "903-310-4950",
            "fax_number": "903-793-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBONU",
        "first_name": "CHARLES",
        "middle_name": "CHIBUNDU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N3171",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "N3171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.