Individual provider Active NPI

Daniel Chinweuba Obi-Ofodile, M.D

  • Family Medicine Physician
  • Pearland, TX
National Provider Identifier
1639489628
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P7524 Issued in TX
Practice address
11901 Shadow Creek Pkwy Ste 111
Pearland, TX 77584-7346
Phone
(281) 760-1971
Fax
(888) 257-3780
NPI assigned
Oct 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 65248 GA
Hospitalist Physician 208M00000X P7524 TX
Family Medicine Physician 207Q00000X P7524 TX Primary

Addresses

Primary practice location

11901 Shadow Creek Pkwy Ste 111
Pearland, TX 77584-7346

Mailing address

11901 Shadow Creek Pkwy Ste 111
Pearland, TX 77584-7346
Phone (281) 760-1971

Other practice location 1

2336 Dawson Rd
Suite 2200
Albany, GA 31707-2800
Phone (229) 312-8800

Other practice location 2

921 Gessner Rd Rm 317
Houston, TX 77024-2501
Phone (713) 242-3768

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
I20140208000247 TX Practitioner - HospitalistPractitioner - Family Practice 8921281692 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65248GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Hospitalist CurrentSince Apr 1, 2017 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
Memorial Hermann Medical Group Family Medicine CurrentSince Sep 9, 2019 Accepting new patients
Hni Medical Services Family Medicine PastSince Mar 1, 2020 Accepting new patients
Phoebe Physician Group, Inc Past Accepting new patients

Locations

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

921 Gessner Rd
Rm 317
Houston, TX 77024
Phone (713) 242-3768

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

909 Frostwood Dr
Ste 1100
Houston, TX 77024
Phone (713) 338-4523

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1639489628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 SHADOW CREEK PKWY STE 111",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847346",
            "telephone_number": "281-760-1971",
            "fax_number": "888-257-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 SHADOW CREEK PKWY STE 111",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847346",
            "telephone_number": "281-760-1971",
            "fax_number": "888-257-3780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2336 Dawson Rd",
            "address_2": "Suite 2200",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "GA",
            "postal_code": "317072800",
            "country_code": "US",
            "telephone_number": "229-312-8800",
            "fax_number": "229-312-8855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "921 Gessner Rd Rm 317",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770242501",
            "country_code": "US",
            "telephone_number": "713-242-3768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBI-OFODILE",
        "first_name": "DANIEL",
        "middle_name": "CHINWEUBA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-08",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "65248",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "P7524",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P7524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.