Provider Demographics
NPI:1831334085
Name:AMADI, KINGSLEY OZICHI
Entity type:Individual
Prefix:
First Name:KINGSLEY
Middle Name:OZICHI
Last Name:AMADI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9894 BISSONNET ST STE 590
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8251
Mailing Address - Country:US
Mailing Address - Phone:713-777-0605
Mailing Address - Fax:713-111-0607
Practice Address - Street 1:9894 BISSONNET ST STE 590
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8251
Practice Address - Country:US
Practice Address - Phone:713-777-0605
Practice Address - Fax:713-111-0607
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74-3137Medicare PIN