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Individual

STEPHEN OGAVU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8123 FARTHING LN, ROSHARON, TX 77583-6634
(832) 228-8483
Mailing address
PO BOX 421854, HOUSTON, TX 77242-1854
(832) 228-8483

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1000163
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000163
EMS PROVIDER LICENCE
TX
Enumeration date
08/21/2008
Last updated
11/05/2008
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