Provider Demographics
NPI:1962951046
Name:EWAH, MICHAEL (BSRRT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:EWAH
Suffix:
Gender:M
Credentials:BSRRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13507 S PEACHFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-2012
Mailing Address - Country:US
Mailing Address - Phone:713-471-3277
Mailing Address - Fax:281-580-4811
Practice Address - Street 1:13507 S PEACHFIELD CIR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-2012
Practice Address - Country:US
Practice Address - Phone:713-471-3277
Practice Address - Fax:281-580-4811
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX507992279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care