Theophilus O. Chukwueke, M.D.,P.a.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

K6824 Issued in TX

Legal business name

THEOPHILUS O. CHUKWUEKE, M.D.,P.A.

Doing business as

The Eye Care Center

Practice address

612 S Twin City Hwy
Nederland, TX 77627-4206

Phone

(409) 724-0794

Fax

(409) 724-7821

NPI assigned

Apr 25, 2012

Last updated

Nov 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theophilus O Chukwueke, M.D.NPI 1114000577

Title

Owner

Phone

(409) 724-0794

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Eye Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theophilus O Chukwueke, M.D.

  • Ophthalmology Physician
  • Orange, TX
  • NPI 1114000577
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1336407519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S TWIN CITY HWY",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776274206",
            "telephone_number": "409-724-0794",
            "fax_number": "409-724-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S TWIN CITY HWY",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776274206",
            "telephone_number": "409-724-0794",
            "fax_number": "409-724-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEOPHILUS O. CHUKWUEKE, M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "CHUKWUEKE",
        "authorized_official_first_name": "THEOPHILUS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-724-0794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "K6824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111991901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Keely Theriot
• Michael P Thomas, MD
• Mark Thompson, LPC
• Minda Lao Toledo, M.D.

• Ophthalmology Physician in Nederland, TX
• Providers in Nederland, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.