Provider Demographics
NPI:1427414333
Name:EKWEDIKE, PRINCE
Entity Type:Individual
Prefix:MR
First Name:PRINCE
Middle Name:
Last Name:EKWEDIKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 GOLDEN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4270
Mailing Address - Country:US
Mailing Address - Phone:281-302-8427
Mailing Address - Fax:
Practice Address - Street 1:2007 GOLDEN CREEK LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-4270
Practice Address - Country:US
Practice Address - Phone:281-302-8427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)