Provider Demographics
NPI:1881826154
Name:OKWOAGU, OSMUND
Entity Type:Individual
Prefix:MR
First Name:OSMUND
Middle Name:
Last Name:OKWOAGU
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 1:9800 CENTRE PKWY # 580
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8271
Mailing Address - Country:US
Mailing Address - Phone:713-995-7939
Mailing Address - Fax:
Practice Address - Street 1:9800 CENTRE PKWY # 580
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8271
Practice Address - Country:US
Practice Address - Phone:713-995-7939
Practice Address - Fax:713-583-1728
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000298341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX364655202OtherEIN