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General NPI Number Information
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NPI Number | 1619276466
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Entity Type | Organization
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Legal Business Name | GAVI HEALTHCARE MANAGEMENT GROUP INC.
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 6701 VICTORY CREST DR # C
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City | ARLINGTON
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State | TX
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Zip | 76002-3672
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Country | US
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Telephone | 817-226-8759
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Fax | 817-466-8756
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Provider Business Mailing Address
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Address Line | 6701 VICTORY CREST DR # C
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City | ARLINGTON
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State | TX
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Zip | 76002-3672
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Country | US
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Telephone | 817-226-8759
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Fax | 817-466-8756
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FRANCIS DEKU
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Credential |
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Telephone | 817-226-8759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 00966
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 00966
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License Number State | TX
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