Provider Demographics
NPI:1477791739
Name:KPADOBI, ANTHONY ONYEME (N/A)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ONYEME
Last Name:KPADOBI
Suffix:
Gender:M
Credentials:N/A
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:10101 FONDREN RD
Mailing Address - Street 2:#427
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4564
Mailing Address - Country:US
Mailing Address - Phone:713-541-0129
Mailing Address - Fax:713-541-0127
Practice Address - Street 1:10101 FONDREN RD
Practice Address - Street 2:#427
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4564
Practice Address - Country:US
Practice Address - Phone:713-541-0129
Practice Address - Fax:713-541-0127
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-25
Last Update Date:2009-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN/A374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide