Individual
ROLAND NDEBANGWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11116 NIGHT CAMP DR, AUSTIN, TX 78754-6113
(737) 296-4201
Mailing address
11116 NIGHT CAMP DR, AUSTIN, TX 78754-6113
(737) 296-4201
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
920941631
—
TX
Enumeration date
11/28/2022
Last updated
11/28/2022
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