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General NPI Number Information
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NPI Number | 1922501808
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Entity Type | Individual
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Provider Name | QUINCY ASSOKU GYEKYE CEO
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Gender | Male
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Dates
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Enumeration Date | 03/16/2018
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Last Update Date | 03/16/2018
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Provider Practice Location Address
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Address Line | 5775 PARKWOOD BLVD APT 1120
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City | FRISCO
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State | TX
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Zip | 75034-7314
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Country | US
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Telephone | 469-703-9419
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Fax |
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Provider Business Mailing Address
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Address Line | 2802 SAINT GEORGE DR
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City | GARLAND
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State | TX
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Zip | 75044-4652
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Country | US
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Telephone | 469-703-9419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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