Irenee Abonegi Lebuabanga

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

2669 Grand Colonial St
Grand Prairie, TX 75054-0258

Phone

(817) 992-9138

NPI assigned

Jul 17, 2020

Sex

Male

Sole proprietor

Yes

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

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.

• Irenee a. Lebuabanga

  • Non-emergency Medical Transport (VAN)
  • Grand Prairie, TX
  • NPI 1174136881
  NPD Authorized official

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1942818786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2669 GRAND COLONIAL ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750540258",
            "telephone_number": "817-992-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 GRAND COLONIAL ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750540258",
            "telephone_number": "817-992-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBUABANGA",
        "first_name": "IRENEE",
        "middle_name": "ABONEGI",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Non-emergency Medical Transport (VAN) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.