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Individual

EGHOSA GABRIEL IGORI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4925 WAMPLER DR, THE COLONY, TX 75056-1024
(469) 379-7405
Mailing address
4629 CHAPMAN ST, THE COLONY, TX 75056-3107
(945) 268-3192

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
171W00000X
Contractor
172A00000X
Driver
Primary
51462457
TX
343900000X
Non-emergency Medical Transport (VAN)
344600000X
Taxi
347C00000X
Private Vehicle

Other

Enumeration date
12/21/2024
Last updated
12/21/2024
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