<Unavail>

LBN: Jerry Ike
<Unavail> is an health care organization with primary practice located at 2306 Oak Ln. Ste 16, Grand Prairie TX 75051. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Jerry Ike can be contacted via phone (972) 262-7752, or through Ike, Jerry J via phone (972) 262-7752.

Contact Information

Primary practice address
2306 Oak Ln. Ste 16 Grand Prairie TX 75051
Phone: (972) 262-7752
Fax: (972) 237-0430
Website:
Map and Directions
Authorized official contact:
Name: Ike, Jerry J
Phone: (972) 262-7752

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 0071940 Texas

Profile Details

NPI number 1154312148
LBN Legal business name Jerry Ike
DBA Doing business as <Unavail>
Authorized official Ike, Jerry J
Entity Organization
Organization subpart 1 No
Enumeration date Oct 31st, 2005
Last updated Nov 23rd, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154312148 NPPES
Texas MEDICAID TPI 170054401
Texas MEDICAID TPI 170054402

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