Individual
RUKEVWE THEODORA AGHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2833 BABCOCK RD, SAN ANTONIO, TX 78229-5390
(210) 450-9890
Mailing address
2810 BABCOCK RD APT 1237, SAN ANTONIO, TX 78229-0026
(210) 847-5716
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP141530
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410153701
—
TX
01
—
410153702
CSHCN
TX
Enumeration date
09/10/2019
Last updated
05/28/2020
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