Basic Information
| Provider Information | |||||||||
| NPI: | 1134489834 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ONYENEKWE | ||||||||
| FirstName: | JESSE | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21216 NORTHWEST FWY | ||||||||
| Address2: | STE 430 | ||||||||
| City: | CYPRESS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774294696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043831003 | ||||||||
| FaxNumber: | 9042447388 | ||||||||
| Practice Location | |||||||||
| Address1: | 655 W 8TH ST, ACC, 1ST FL, PRIMARY CARE CENTER | ||||||||
| Address2: | UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE-JACKSONVILLE | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322096511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043831003 | ||||||||
| FaxNumber: | 9042447388 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2012 | ||||||||
| LastUpdateDate: | 07/06/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | R7839 | TX | Y | Other Service Providers | Specialist |
No ID Information.