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General NPI Number Information
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NPI Number | 1639905763
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Entity Type | Organization
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Legal Business Name | BLUE RIBBON ENT, ALLERGY & SINUS CENTER PLLC
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 7616 BRANFORD PL STE 350
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City | SUGAR LAND
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State | TX
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Zip | 77479-3794
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Country | US
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Telephone | 281-843-4364
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Fax | 281-720-8743
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Provider Business Mailing Address
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Address Line | 7616 BRANFORD PL STE 350
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City | SUGAR LAND
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State | TX
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Zip | 77479-3794
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Country | US
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Telephone | 956-655-7015
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. SUSAN OMWANGHE EDIONWE
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Credential | MD
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Telephone | 281-843-4364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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