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PROSPERITY EZEANUNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1673 BRIARCREST DR STE 100B, BRYAN, TX 77802-2756
(979) 985-5339
(979) 705-3505
Mailing address
1673 BRIARCREST DR STE 100B, BRYAN, TX 77802-2756
(979) 985-5339
(979) 705-3505

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
N4405
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30207833
NH
05
532956099
ME
Enumeration date
01/30/2007
Last updated
03/02/2017
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