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General NPI Number Information
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NPI Number | 1164458360
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Entity Type | Organization
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Legal Business Name | IKE GINIS
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 777 S CENTRAL EXPY SUITE 1B
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City | RICHARDSON
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State | TX
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Zip | 75080-7411
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Country | US
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Telephone | 972-699-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 777 S CENTRAL EXPY SUITE 1B
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City | RICHARDSON
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State | TX
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Zip | 75080-7411
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Country | US
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Telephone | 972-699-7600
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | IKE GINIS
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Credential |
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Telephone | 972-699-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0062948
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License Number State | TX
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