Organization
AMBONI HEALTHSOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PROSPER KISWAGA (MD)
(214) 830-9906
Entity
Organization
Contact information
Practice address
25630 FARRIER DR, RICHMOND, TX 77406-1468
(214) 830-9906
Mailing address
25630 FARRIER DR, RICHMOND, TX 77406-1468
(214) 830-9906
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/27/2020
Last updated
06/13/2024
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