Provider Demographics
NPI:1902001779
Name:STEVE CHIKE ECHETABU
Entity Type:Organization
Organization Name:STEVE CHIKE ECHETABU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:CHIKE
Authorized Official - Last Name:ECHETABU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-278-8712
Mailing Address - Street 1:2722 W KINGSLEY RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-2442
Mailing Address - Country:US
Mailing Address - Phone:972-278-8712
Mailing Address - Fax:972-278-8719
Practice Address - Street 1:2722 W KINGSLEY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-2442
Practice Address - Country:US
Practice Address - Phone:972-278-8712
Practice Address - Fax:972-278-8719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6011360001Medicare NSC