Individual
AGNETA WAVINYA KIOKO IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4224 GLEN ABBEY DR, CROWLEY, TX 76036-8528
(214) 729-9323
Mailing address
4224 GLENN ABBEY CROWLEY, 4224 GLENN ABBEY CROWLEY, CROWLEY, TX 76036
(214) 729-9323
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
351812
TX
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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