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NPI Code Detail

MEDICARE: OSAZE KEN OSEMWENGIE

MEDICARE: OSAZE KEN OSEMWENGIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP139103TX

General Provider Information

NPI Number : 1023585809
Entity Type Code : Individual
Provider Name (Legal Business Name) : OSAZE KEN OSEMWENGIE
Provider Business Mailing Address
First Line : 2621 CEDAR VIEW DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76006-2818
Country : US
Telephone Number : 817-946-3318
Fax Number :
Provider Business Practice Location Address
First Line : 2000 E LAMAR BLVD STE 600
Second Line :
City : ARLINGTON
State : TX
Zip : 76006-7361
Country : US
Telephone Number : 817-946-3188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2018
Last Update Date : 01/18/2019

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Directions to “ OSAZE KEN OSEMWENGIE ” Practice Location

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