MEDICARE: STANLEY EROVWO

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	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1861384919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANLEY EROVWO

Provider Business Mailing Address
First Line	:	4821 NORTH O'CONNOR ROAD
Second Line	:	APT. 243
City	:	IRVING
State	:	TX
Zip	:	75062-9998
Country	:	US
Telephone Number	:	469-457-8998
Fax Number	:	469-457-8998

Provider Business Practice Location Address
First Line	:	4821 NORTH O'CONNOR ROAD
Second Line	:	APT. 243
City	:	IRVING
State	:	TX
Zip	:	75062-9998
Country	:	US
Telephone Number	:	469-457-8998
Fax Number	:	469-457-8998

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

Provider Enumeration Date	:	07/15/2025
Last Update Date	:	07/15/2025

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Directions to “ STANLEY EROVWO ” Practice Location

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