MEDICARE: EMMANUEL NNAMDI NNAJI

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
1	171W00000X	Contractor
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1467833913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL NNAMDI NNAJI

Provider Business Mailing Address
First Line	:	5827 CRESTVIEW CV
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-6259
Country	:	US
Telephone Number	:	832-375-9718
Fax Number	:

Provider Business Practice Location Address
First Line	:	2651 CARTWRIGHT RD STE I&H
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2635
Country	:	US
Telephone Number	:	832-375-9718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2015
Last Update Date	:	06/10/2015

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