Individual
MR. EMMANUEL AGWAGOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1515 GREY WILLOW LN, ARLINGTON, TX 76002-4633
(817) 719-3775
(817) 704-4046
Mailing address
1515 GREY WILLOW LN, ARLINGTON, TX 76002-4633
(817) 719-3775
(817) 704-4046
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
742099
TX
163WC1500X
Community Health Registered Nurse
26NR11805800
NJ
171M00000X
Case Manager/Care Coordinator
Primary
742099
TX
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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