Provider Demographics
NPI:1508547530
Name:WARREN, LILIAN JUDY WANGARI (NEMT)
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:JUDY WANGARI
Last Name:WARREN
Suffix:
Gender:F
Credentials:NEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 US HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-7386
Mailing Address - Country:US
Mailing Address - Phone:936-730-9553
Mailing Address - Fax:
Practice Address - Street 1:1676 US HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-7386
Practice Address - Country:US
Practice Address - Phone:936-730-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty