Provider Demographics
NPI:1649384363
Name:JAMES ARUA AGBEZE
Entity Type:Organization
Organization Name:JAMES ARUA AGBEZE
Other - Org Name:BROWNE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ARUA
Authorized Official - Last Name:AGBEZE
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER/OWNER
Authorized Official - Phone:281-313-9222
Mailing Address - Street 1:104 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3180
Mailing Address - Country:US
Mailing Address - Phone:281-313-9222
Mailing Address - Fax:281-313-9223
Practice Address - Street 1:104 INDUSTRIAL BLVD.
Practice Address - Street 2:SUITE 209
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3174
Practice Address - Country:US
Practice Address - Phone:281-313-9222
Practice Address - Fax:281-313-9223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0065428332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157879102Medicaid
TX157879102Medicaid