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Individual

MR. SAM CHUKWUEMEKA IHEKWOABA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
13403 ELDRIDGE VILLA ST, SUGAR LAND, TX 77498-2282
(281) 277-5614
Mailing address
13403 ELDRIDGE VILLA ST, SUGAR LAND, TX 77498-2282
(281) 277-5614

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
09/07/2010
Last updated
09/07/2010
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