Provider Demographics
NPI:1780857102
Name:OGIRI, MANUWA MORGAN
Entity Type:Individual
Prefix:MR
First Name:MANUWA
Middle Name:MORGAN
Last Name:OGIRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13999 GOLDMARK DR STE 328
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4269
Mailing Address - Country:US
Mailing Address - Phone:469-330-8188
Mailing Address - Fax:469-330-8170
Practice Address - Street 1:13999 GOLDMARK DR STE 328
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4269
Practice Address - Country:US
Practice Address - Phone:469-330-8188
Practice Address - Fax:469-330-8170
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0103015332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies