Provider Demographics
NPI:1942041850
Name:EZE, ADIMORA
Entity type:Individual
Prefix:
First Name:ADIMORA
Middle Name:
Last Name:EZE
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 1:13115 WHITTINGTON DR
Mailing Address - Street 2:APT 10207
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077
Mailing Address - Country:US
Mailing Address - Phone:832-946-6634
Mailing Address - Fax:
Practice Address - Street 1:801 TRAVIS ST STE 2101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5730
Practice Address - Country:US
Practice Address - Phone:833-946-6634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX726642146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic