Provider Demographics
NPI:1831667146
Name:GAP EPILOGUE
Entity Type:Organization
Organization Name:GAP EPILOGUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:OGWUMIKE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:346-242-0275
Mailing Address - Street 1:10000 BROADWAY ST APT 662
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7838
Mailing Address - Country:US
Mailing Address - Phone:346-242-0275
Mailing Address - Fax:713-456-2260
Practice Address - Street 1:10000 BROADWAY ST APT 662
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7838
Practice Address - Country:US
Practice Address - Phone:346-242-0275
Practice Address - Fax:713-456-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management