Provider Demographics
NPI:1326269796
Name:MAXWELL PROVIDERS, INC
Entity Type:Organization
Organization Name:MAXWELL PROVIDERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMENZE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAZUWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-783-7703
Mailing Address - Street 1:7457 HARWIN DR
Mailing Address - Street 2:STE 130
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:713-783-7703
Mailing Address - Fax:713-783-7519
Practice Address - Street 1:7457 HARWIN DR
Practice Address - Street 2:#130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2018
Practice Address - Country:US
Practice Address - Phone:713-783-7703
Practice Address - Fax:713-783-7519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty