Healthcare Provider Details

I. General information

NPI: 1881826154
Provider Name (Legal Business Name): MR. OSMUND OKWOAGU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 09/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 CENTRE PKWY # 580
HOUSTON TX
77036-8271
US

IV. Provider business mailing address

9800 CENTRE PKWY # 580
HOUSTON TX
77036-8271
US

V. Phone/Fax

Practice location:
  • Phone: 713-995-7939
  • Fax: 713-583-1728
Mailing address:
  • Phone: 713-995-7939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1000298
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: