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General NPI Number Information
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NPI Number | 1851320022
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Entity Type | Organization
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Legal Business Name | JAZA CORPORATION
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 10721 PLANO RD SUITE 200
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City | DALLAS
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State | TX
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Zip | 75238-5348
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Country | US
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Telephone | 214-340-7458
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Fax | 214-341-9034
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Provider Business Mailing Address
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Address Line | 10721 PLANO RD SUITE 200
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City | DALLAS
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State | TX
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Zip | 75238-5348
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Country | US
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Telephone | 214-340-7458
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Fax | 214-341-9034
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID E ODEMWINGIE
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Credential |
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Telephone | 214-340-7458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 0043164
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0043164
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License Number State | TX
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