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NPI Code Detail

MEDICARE: MR. NNACHEBE FESTUS EZECHIGBO

MEDICARE: MR. NNACHEBE FESTUS EZECHIGBO
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
1225200000XPhysical Therapy Assistant2044477
2225200000XPhysical Therapy Assistant2044477TX

General Provider Information

NPI Number : 1659847747
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NNACHEBE FESTUS EZECHIGBO
Provider Business Mailing Address
First Line : 4300 VISTA RD
Second Line :
City : PASADENA
State : TX
Zip : 77504-2118
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4300 VISTA RD
Second Line :
City : PASADENA
State : TX
Zip : 77504-2118
Country : US
Telephone Number : 713-946-6787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2018
Last Update Date : 10/17/2018

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