Provider Demographics
NPI:1326644923
Name:DASUTH LLC
Entity Type:Organization
Organization Name:DASUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-875-9439
Mailing Address - Street 1:7346 ANTOINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-7230
Mailing Address - Country:US
Mailing Address - Phone:832-328-8330
Mailing Address - Fax:832-328-8331
Practice Address - Street 1:7346 ANTOINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-7230
Practice Address - Country:US
Practice Address - Phone:832-328-8330
Practice Address - Fax:832-328-8331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy