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General NPI Number Information
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NPI Number | 1043395197
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Entity Type | Individual
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Provider Name | MR. CORNELIUS NWOKENAKA
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 9888 BISSONNET ST SUITE 410
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City | HOUSTON
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State | TX
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Zip | 77036-8247
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Country | US
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Telephone | 713-541-1667
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Fax | 713-541-2669
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Provider Business Mailing Address
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Address Line | 9888 BISSONNET ST SUITE 410
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City | HOUSTON
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State | TX
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Zip | 77036-8247
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Country | US
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Telephone | 713-541-1667
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Fax | 713-541-2669
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0063812
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License Number State | TX
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