Andargachew B Seyoum

Primary specialty

DriverTaxonomy code 172A00000X

License

0805889178 Issued in TX

Practice address

2302 Peach Oak Xing
Manvel, TX 77578-4157

Phone

(702) 684-0083

NPI assigned

Feb 10, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Easymed Transport

  • Secured Medical Transport (VAN)
  • Manvel, TX
  • NPI 1730986969
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1750196556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 PEACH OAK XING",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "775784157",
            "telephone_number": "702-684-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 PEACH OAK XING",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "775784157",
            "telephone_number": "702-684-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYOUM",
        "first_name": "ANDARGACHEW",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "TX",
            "license": "0805889178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Manvel, TX
• Driver in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.