Provider Demographics
NPI:1003004052
Name:DE GINO CORPORATION LLC
Entity Type:Organization
Organization Name:DE GINO CORPORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:EZEKPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-449-4460
Mailing Address - Street 1:7447 HARWIN DR
Mailing Address - Street 2:SUITE 220C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2016
Mailing Address - Country:US
Mailing Address - Phone:713-600-0606
Mailing Address - Fax:713-600-0607
Practice Address - Street 1:7447 HARWIN DR
Practice Address - Street 2:SUITE 220C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2016
Practice Address - Country:US
Practice Address - Phone:713-600-0606
Practice Address - Fax:713-600-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies