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Organization
QAVENI HOLDING LLC
Active
Organization
QAVENI HOLDING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAMIAN OKPAKO IDJAGBORO PA (CEO)
(832) 366-5980
Entity
Organization
Contact information
Practice address
8449 W BELLFORT ST, SUITE 285, HOUSTON, TX 77071-2245
(832) 366-5980
(713) 900-6007
Mailing address
8449 WEST BELLFORT ROAD, SUITE 285, HOUSTON, TX 77071
(832) 366-5980
(713) 900-6007
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
363A00000X
Physician Assistant
Primary
PA03357
TX
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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