Provider Demographics
NPI:1831195429
Name:MGA MEDICAL EQUIPMENT, INC.
Entity type:Organization
Organization Name:MGA MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:GODFREY
Authorized Official - Last Name:IWUNZE
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:972-685-5380
Mailing Address - Street 1:PO BOX 742394
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-2394
Mailing Address - Country:US
Mailing Address - Phone:972-685-5380
Mailing Address - Fax:972-685-5390
Practice Address - Street 1:9550 FOREST LN STE 207
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6099
Practice Address - Country:US
Practice Address - Phone:972-685-5380
Practice Address - Fax:972-685-5390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001062332BN1400X, 332BP3500X, 251J00000X, 332B00000X
TX0072889332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166477301Medicaid
TX166477302Medicaid
TX166477301Medicaid