Provider Demographics
NPI:1538487855
Name:JERRY ONWUGAMBA
Entity Type:Organization
Organization Name:JERRY ONWUGAMBA
Other - Org Name:EKO-STAR EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUGAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-931-0815
Mailing Address - Street 1:PO BOX 31066
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77231-1066
Mailing Address - Country:US
Mailing Address - Phone:713-931-0815
Mailing Address - Fax:832-553-2996
Practice Address - Street 1:620 MURPHY RD STE 208
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5927
Practice Address - Country:US
Practice Address - Phone:713-931-0815
Practice Address - Fax:832-553-2996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10003863416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport