Individual
HENDRICKS AGWU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 KATHRYN DR BLDG 3, LEWISVILLE, TX 75067-4216
(800) 972-0643
Mailing address
7240 ROBLE, GRAND PRAIRIE, TX 75054-0100
(347) 247-2959
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1052379
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61183839
WA
Other
Enumeration date
09/30/2009
Last updated
09/06/2022
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