MEDICARE: MR. YOUNG OKORO ANYANWU

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	372600000X	Adult Companion
2	372600000X	Adult Companion		TX

General Provider Information

NPI Number	:	1891926242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YOUNG OKORO ANYANWU

Provider Business Mailing Address
First Line	:	16010 PASADERO DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-2921
Country	:	US
Telephone Number	:	832-877-1340
Fax Number	:	281-383-9961

Provider Business Practice Location Address
First Line	:	16010 PASADERO DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-2921
Country	:	US
Telephone Number	:	832-877-1340
Fax Number	:	281-383-9961

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

Provider Enumeration Date	:	08/03/2009
Last Update Date	:	08/03/2009

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