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NPI 1205021573

NPI 1205021573 : CASMIR EGEMASI : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1205021573
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    Entity Type          |    Organization 
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    Legal Business Name  |    CASMIR EGEMASI 
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Dates
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    Enumeration Date     |    09/10/2007
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    Last Update Date     |    06/19/2008
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Provider Practice Location Address
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    Address Line         |    9304 FOREST LN 234
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75243-6238
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    Country              |    US
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    Telephone            |    214-503-3733
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9304 FOREST LN 234
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75243-6238
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    Country              |    US
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    Telephone            |    214-503-3733
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |    MR. CASMIR IFEANYI EGEMASI 
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    Credential           |    
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    Telephone            |    214-503-3733
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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       |    0098844
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    License Number State |    TX
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