Provider Demographics
NPI:1962605386
Name:ABENGOWE, NZENWATA
Entity type:Individual
Prefix:MR
First Name:NZENWATA
Middle Name:
Last Name:ABENGOWE
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 1:5518 DYER ST
Mailing Address - Street 2:SUIT #17
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5081
Mailing Address - Country:US
Mailing Address - Phone:214-228-3292
Mailing Address - Fax:
Practice Address - Street 1:5518 DYER ST
Practice Address - Street 2:SUIT #17
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5081
Practice Address - Country:US
Practice Address - Phone:214-228-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor