Provider Demographics
NPI:1508154394
Name:ANUGWOM, OBIAGELI EVANGELINE
Entity Type:Individual
Prefix:MRS
First Name:OBIAGELI
Middle Name:EVANGELINE
Last Name:ANUGWOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7211 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-3507
Mailing Address - Country:US
Mailing Address - Phone:832-767-7677
Mailing Address - Fax:
Practice Address - Street 1:7211 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3507
Practice Address - Country:US
Practice Address - Phone:832-767-7677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator