Healthcare Provider Details

I. General information

NPI: 1831334085
Provider Name (Legal Business Name): KINGSLEY OZICHI AMADI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2008
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9894 BISSONNET ST STE 590
HOUSTON TX
77036-8251
US

IV. Provider business mailing address

9894 BISSONNET ST STE 590
HOUSTON TX
77036-8251
US

V. Phone/Fax

Practice location:
  • Phone: 713-777-0605
  • Fax: 713-111-0607
Mailing address:
  • Phone: 713-777-0605
  • Fax: 713-111-0607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: