Provider Demographics
NPI:1871933911
Name:AUGUSTINE OHWONIGHO AVWORO SR
Entity type:Organization
Organization Name:AUGUSTINE OHWONIGHO AVWORO SR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:O
Authorized Official - Last Name:AVWORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-410-2089
Mailing Address - Street 1:12738 VILLAWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-4616
Mailing Address - Country:US
Mailing Address - Phone:832-410-2089
Mailing Address - Fax:281-498-8243
Practice Address - Street 1:12738 VILLAWOOD LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-4616
Practice Address - Country:US
Practice Address - Phone:832-410-2089
Practice Address - Fax:281-498-8243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10007793416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport