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General NPI Number Information
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NPI Number | 1669618013
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Entity Type | Organization
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Legal Business Name | MAXWELL C. NWANEBU
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 7901 CAMERON RD BUILDING 2, SUIT 319
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City | AUSTIN
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State | TX
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Zip | 78754-3831
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Country | US
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Telephone | 512-821-2657
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Fax | 512-821-2216
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Provider Business Mailing Address
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Address Line | 7901 CAMERON RD BUILDING 2, SUIT 319
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City | AUSTIN
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State | TX
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Zip | 78754-3831
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Country | US
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Telephone | 512-821-2657
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Fax | 512-821-2216
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Authorized Official
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Title or Position | DIRECTOR
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Name | MAXWELL CHINAGOZI NWANEBU
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Credential |
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Telephone | 512-821-2657
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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 |
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License Number State |
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