Provider Demographics
NPI:1922552702
Name:BAMIJOKO, ZACCHAEUS
Entity type:Individual
Prefix:
First Name:ZACCHAEUS
Middle Name:
Last Name:BAMIJOKO
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 1:11450 BISSONNET ST
Mailing Address - Street 2:304
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1900
Mailing Address - Country:US
Mailing Address - Phone:281-995-2452
Mailing Address - Fax:
Practice Address - Street 1:2380 S MACGREGOR WAY
Practice Address - Street 2:431
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1159
Practice Address - Country:US
Practice Address - Phone:281-995-2452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)