Provider Demographics
NPI:1073725974
Name:DIOH, LAWRENCE MUKETE
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:MUKETE
Last Name:DIOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6250 WESTPARK DR
Mailing Address - Street 2:STE 330C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7322
Mailing Address - Country:US
Mailing Address - Phone:713-278-1603
Mailing Address - Fax:713-278-1674
Practice Address - Street 1:6250 WESTPARK DR
Practice Address - Street 2:STE 330C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7322
Practice Address - Country:US
Practice Address - Phone:713-278-1603
Practice Address - Fax:713-278-1674
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No341600000XTransportation ServicesAmbulance
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6039720001Medicare NSC