Provider Demographics
NPI:1275343279
Name:EGBEGBETORO, RHEMRURU
Entity type:Individual
Prefix:
First Name:RHEMRURU
Middle Name:
Last Name:EGBEGBETORO
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 1:20403 BARON BEND LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-0200
Mailing Address - Country:US
Mailing Address - Phone:346-732-6982
Mailing Address - Fax:
Practice Address - Street 1:20403 BARON BEND LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-0200
Practice Address - Country:US
Practice Address - Phone:346-732-6982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies