Provider Demographics
NPI:1629633235
Name:MBARAONYE, UCHENNE EVANS (DO)
Entity type:Individual
Prefix:
First Name:UCHENNE
Middle Name:EVANS
Last Name:MBARAONYE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 GILMER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-2133
Mailing Address - Country:US
Mailing Address - Phone:903-488-2273
Mailing Address - Fax:
Practice Address - Street 1:3521 N FOURTH ST STE 100
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605
Practice Address - Country:US
Practice Address - Phone:903-488-2273
Practice Address - Fax:773-825-8352
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV4708207R00000X
MO2021048004207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine