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Organization

AFAHA M ASANGANSI

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. AFAHA MATTHEW ASANGANSI (OWNER OPERATOR)
(903) 509-3987
Entity
Organization

Contact information

Practice address
7524 S BROADWAY AVE, STE120, TYLER, TX 75703-5007
(903) 509-3987
(903) 509-9428
Mailing address
7524 S BROADWAY AVE, SUITE 120, TYLER, TX 75703-5007
(903) 509-3987
(903) 509-9428

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
161161801
TX

Other

Enumeration date
08/09/2005
Last updated
08/03/2011
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