MEDICARE: OSAROBO GEORGE OMOROSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle		TX

General Provider Information

NPI Number	:	1477409878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSAROBO GEORGE OMOROSE

Provider Business Mailing Address
First Line	:	19101 KUYKENDAHL RD APT 3213
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-5565
Country	:	US
Telephone Number	:	917-893-0658
Fax Number	:

Provider Business Practice Location Address
First Line	:	19101 KUYKENDAHL RD APT 3213
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-5565
Country	:	US
Telephone Number	:	917-893-0658
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/19/2026

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Directions to “ OSAROBO GEORGE OMOROSE ” Practice Location

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