Provider Demographics
NPI:1205026333
Name:UBESIE, KANENECHUKWU VIRGINIA (MD, MBA, FACS)
Entity type:Individual
Prefix:DR
First Name:KANENECHUKWU
Middle Name:VIRGINIA
Last Name:UBESIE
Suffix:
Gender:F
Credentials:MD, MBA, FACS
Other - Prefix:
Other - First Name:KANENE
Other - Middle Name:V
Other - Last Name:UBESIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MBA, FACS
Mailing Address - Street 1:8700 STONEBROOK PKWY UNIT 958
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5804
Mailing Address - Country:US
Mailing Address - Phone:972-850-6122
Mailing Address - Fax:
Practice Address - Street 1:4333 N JOSEY LN STE 101
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4620
Practice Address - Country:US
Practice Address - Phone:972-850-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ67162086S0127X, 2086S0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care