Provider Demographics
NPI:1346641990
Name:US DEJA VU SERVICES, INC.
Entity Type:Organization
Organization Name:US DEJA VU SERVICES, INC.
Other - Org Name:GRACIOUS TRANSPORTATION SERVICES COMPANY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TINASHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNYARADZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-455-2355
Mailing Address - Street 1:2424 POINCIANA PL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75212-1556
Mailing Address - Country:US
Mailing Address - Phone:817-455-2355
Mailing Address - Fax:
Practice Address - Street 1:2424 POINCIANA PL
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-1556
Practice Address - Country:US
Practice Address - Phone:817-455-2355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)