Provider Demographics
NPI:1003653312
Name:EPIORGE TECHNOLOGIES LLC
Entity type:Organization
Organization Name:EPIORGE TECHNOLOGIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JURCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-901-9081
Mailing Address - Street 1:7881 W CHARLESTON BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8327
Mailing Address - Country:US
Mailing Address - Phone:702-901-9081
Mailing Address - Fax:
Practice Address - Street 1:1237 SILVERWOOD DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-8233
Practice Address - Country:US
Practice Address - Phone:817-470-3896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty