Provider Demographics
NPI:1326209487
Name:EASTGATE HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:EASTGATE HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHINEDU
Authorized Official - Middle Name:E
Authorized Official - Last Name:OKWARA
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:832-446-6980
Mailing Address - Street 1:9100 SOUTHWEST FWY STE 249
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1524
Mailing Address - Country:US
Mailing Address - Phone:832-446-6980
Mailing Address - Fax:832-446-6978
Practice Address - Street 1:9100 SOUTHWEST FWY STE 249
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1524
Practice Address - Country:US
Practice Address - Phone:832-446-6980
Practice Address - Fax:832-446-6978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-21
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
747448OtherMEDICARE CERTIFICATION/ PTAN
TX3245896Medicaid