Provider Demographics
NPI:1366638884
Name:INYANG, AGLASS N (PRESIDENT)
Entity type:Individual
Prefix:MR
First Name:AGLASS
Middle Name:N
Last Name:INYANG
Suffix:
Gender:M
Credentials:PRESIDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE L
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3180
Mailing Address - Country:US
Mailing Address - Phone:281-491-4091
Mailing Address - Fax:281-491-8183
Practice Address - Street 1:104 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE L
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3180
Practice Address - Country:US
Practice Address - Phone:281-491-4091
Practice Address - Fax:281-491-8183
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX14205171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0097147OtherFOOD WHOLESALER & DEVICE