1053837054 NPI number — LION OF JUDAH TRANSPORTATION, INC

Table of content: ELIF IPEK KUGUOGLU MD (NPI 1851195945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053837054 NPI number — LION OF JUDAH TRANSPORTATION, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LION OF JUDAH TRANSPORTATION, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053837054
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6919 SANDY KNOLLS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77379-4822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-449-4382
Provider Business Mailing Address Fax Number:
281-667-3116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13512 HOMESTEAD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77039-2726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-449-4382
Provider Business Practice Location Address Fax Number:
281-667-3116
Provider Enumeration Date:
08/21/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SHEPPARD
Authorized Official First Name:
ANDROS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
281-449-4382

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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