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NPI Code Detail

MEDICARE: BRICE MBAMEG MAHENDJE

MEDICARE:   BRICE  MBAMEG MAHENDJE
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
1172A00000XDriver

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558736009
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRICE MBAMEG MAHENDJE
Provider Business Mailing Address
First Line : 5258 SAN PABLO GARDENS DR
Second Line :
City : HOUSTON
State : TX
Zip : 77045-4043
Country : US
Telephone Number : 832-507-8769
Fax Number :
Provider Business Practice Location Address
First Line : 5258 SAN PABLO GARDENS DR
Second Line :
City : HOUSTON
State : TX
Zip : 77045-4043
Country : US
Telephone Number : 832-507-8769
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2015
Last Update Date : 12/09/2015

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Directions to “ BRICE MBAMEG MAHENDJE ” Practice Location

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