Provider Demographics
NPI:1821715913
Name:AMODU, BASHIR
Entity Type:Individual
Prefix:
First Name:BASHIR
Middle Name:
Last Name:AMODU
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:PO BOX 770174
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77215-0174
Mailing Address - Country:US
Mailing Address - Phone:346-300-2265
Mailing Address - Fax:
Practice Address - Street 1:12910 ASHFORD POINT DR APT 46
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5251
Practice Address - Country:US
Practice Address - Phone:346-300-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)