Provider Demographics
NPI:1881164226
Name:ANDROGENX
Entity type:Organization
Organization Name:ANDROGENX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MISS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:617-459-3946
Mailing Address - Street 1:18201 GULF FWY UNIT C
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-3806
Mailing Address - Country:US
Mailing Address - Phone:409-934-2981
Mailing Address - Fax:833-213-0893
Practice Address - Street 1:18201 GULF FWY UNIT C
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-3806
Practice Address - Country:US
Practice Address - Phone:281-954-6200
Practice Address - Fax:833-213-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty