Individual
MR. VICTOR AGBEMAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18806 PROVIDENCE VALLEY TRL, RICHMOND, TX 77407-2013
(571) 420-4797
Mailing address
18806 PROVIDENCE VALLEY TRL, RICHMOND, TX 77407-2013
(571) 420-4797
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
343800000X
Secured Medical Transport (VAN)
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
41531606
TX
Other
Enumeration date
10/31/2022
Last updated
11/22/2022
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