Provider Demographics
NPI:1346249802
Name:MUNACHI ONYEDEBELU
Entity Type:Organization
Organization Name:MUNACHI ONYEDEBELU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON ADMIN
Authorized Official - Prefix:MISS
Authorized Official - First Name:MUNACHI
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONYEDEBELU
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:281-261-8111
Mailing Address - Street 1:2440 TEXAS PKWY, 340
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-4023
Mailing Address - Country:US
Mailing Address - Phone:281-261-8111
Mailing Address - Fax:281-261-8109
Practice Address - Street 1:2440 TEXAS PKWY
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4023
Practice Address - Country:US
Practice Address - Phone:281-261-8111
Practice Address - Fax:281-261-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008619251E00000X
TX251E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00101311Medicaid
TX008629OtherTEXAS DEPARTMENT OF AGING
TX17016602Medicaid
4740620001Medicare NSC
TX673140Medicare ID - Type UnspecifiedHHA