Provider Demographics
NPI:1598959355
Name:NWANKWO, KANU KANU (LMRT)
Entity Type:Individual
Prefix:MR
First Name:KANU
Middle Name:KANU
Last Name:NWANKWO
Suffix:
Gender:M
Credentials:LMRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11311 BAYOU PLACE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-4243
Mailing Address - Country:US
Mailing Address - Phone:832-754-9499
Mailing Address - Fax:281-530-1415
Practice Address - Street 1:11311 BAYOU PLACE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-4243
Practice Address - Country:US
Practice Address - Phone:832-754-9499
Practice Address - Fax:281-530-1415
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2005192471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography