Provider Demographics
NPI:1356001705
Name:AGBOR, MAUREEN (RN)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:AGBOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15211 PREACHERS LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-2290
Mailing Address - Country:US
Mailing Address - Phone:214-493-6365
Mailing Address - Fax:
Practice Address - Street 1:15211 PREACHERS LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-2290
Practice Address - Country:US
Practice Address - Phone:214-493-6365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX987844163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health