Provider Demographics
NPI:1740486729
Name:GTA NURSE STAFFING
Entity type:Organization
Organization Name:GTA NURSE STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOLOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-713-3961
Mailing Address - Street 1:1700 COMMERCE ST STE 1640
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-5364
Mailing Address - Country:US
Mailing Address - Phone:469-713-3961
Mailing Address - Fax:866-806-4316
Practice Address - Street 1:1700 COMMERCE ST STE 1640
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-5364
Practice Address - Country:US
Practice Address - Phone:469-713-3961
Practice Address - Fax:866-806-4316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient