Individual
GLADYS EZIMAKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 WATER SPANIEL WAY, ROUND ROCK, TX 78664-3414
(512) 212-1108
Mailing address
1205 WATER SPANIEL WAY, ROUND ROCK, TX 78664-3414
(512) 212-1108
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
017038
TX
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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