Emmanuel Agwagom, RN
Individual provider Active NPI Case Manager/Care Coordinator · Arlington, TX
NPI 1114249299 · NPPES record last updated Feb 17, 2010
Key facts
- NPI
- 1114249299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 742099 (TX)
- Practice address
- 1515 Grey Willow LN
Arlington, TX 76002-4633 - Phone
- (817) 719-3775
- Fax
- (817) 704-4046
- NPI assigned
- Feb 17, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR11805800 | NJ | MD | Community Health Registered Nurse |
| 742099 | TX | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Healthcare Solutions | Past | Accepting new patients | |
| American Healthcare Solutions, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 742099 | TX | |
| Community Health Registered Nurse | 163WC1500X | 26NR11805800 | NJ | |
| Case Manager/Care Coordinator | 171M00000X | 742099 | TX | Yes |
Addresses
Primary practice location
1515 Grey Willow LN
Arlington, TX 76002-4633
Mailing address
1515 Grey Willow LN
Arlington, TX 76002-4633
Phone (817) 719-3775
Other providers in Arlington, TX
- Adoracion Aguiar
- Judith Aguilar
- Nicolas Aguilar
- Romeo A Aguilar
- Mariela Maribel Aguillon
- Kimberly Agwu
- Ah Dentistry of Arlington
- Mansour Ahangaradeh
- Amanze Aharanwa
- Augusta I Aharanwa
All providers in Arlington, TX · Case Manager/Care Coordinator in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.