Doctor Name: | JERRY ONWUGAMBA |
NPI Number: | 1033448006 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 620 Murphy Rd Suite 208 Stafford, TX - 774775927 |
Business Phone Number: | 2817488357 |
Business Fax Number: | |
Mailing Address: | 620 Murphy Rd, Suite 208 STAFFORD |
State: | TX |
Postal Code: | 774775927 |
Phone Number: | 2817488357 |
Fax Number: | |
NPI Enumeration Date: | 12/21/2009 |
NPI Last Update Date: | 08/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416L0300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Land Transport |
Taxonomy Definition: |