Individual
MR. IRENEE ABONEGI LEBUABANGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2669 GRAND COLONIAL ST, GRAND PRAIRIE, TX 75054-0258
(817) 992-9138
Mailing address
2669 GRAND COLONIAL ST, GRAND PRAIRIE, TX 75054-0258
(817) 992-9138
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/17/2020
Last updated
07/17/2020
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