Provider Demographics
NPI:1538729611
Name:SUNDAYI, AGNES CHARITY
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:CHARITY
Last Name:SUNDAYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 CREEKVIEW DR APT 103
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-3468
Mailing Address - Country:US
Mailing Address - Phone:817-673-6830
Mailing Address - Fax:
Practice Address - Street 1:213 CREEKVIEW DR APT 103
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-3468
Practice Address - Country:US
Practice Address - Phone:817-673-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX43450891OtherTEXAS