Individual
MR. IKECHUKWU STANISLAUS IWUNNAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3201 IH 30 STE C2, MESQUITE, TX 75150-2602
(972) 279-0643
(972) 279-0543
Mailing address
3201 IH-30 STE C2, MESQUITE, TX 75150-2602
(972) 279-0643
(972) 279-0543
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
0109451
TX
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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