Provider Demographics
NPI:1205021573
Name:CASMIR EGEMASI
Entity Type:Organization
Organization Name:CASMIR EGEMASI
Other - Org Name:ICETOWERS GROUP OF COMPANIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CASMIR
Authorized Official - Middle Name:IFEANYI
Authorized Official - Last Name:EGEMASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-503-3733
Mailing Address - Street 1:9304 FOREST LN
Mailing Address - Street 2:234
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6238
Mailing Address - Country:US
Mailing Address - Phone:214-503-3733
Mailing Address - Fax:
Practice Address - Street 1:9304 FOREST LN
Practice Address - Street 2:234
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:214-503-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0098844332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6029510001Medicare NSC