Provider Demographics
NPI:1144492539
Name:LAMBORGHINI TECHNOLOGIES
Entity type:Organization
Organization Name:LAMBORGHINI TECHNOLOGIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALPHONSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTSINDASHYAKA
Authorized Official - Suffix:
Authorized Official - Credentials:ENGINEER
Authorized Official - Phone:713-996-9300
Mailing Address - Street 1:2870 GESSNER RD. SUITE A3
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080
Mailing Address - Country:US
Mailing Address - Phone:713-996-9300
Mailing Address - Fax:713-996-9300
Practice Address - Street 1:2870 GESSNER RD. SUITE A3
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080
Practice Address - Country:US
Practice Address - Phone:713-996-9300
Practice Address - Fax:713-996-9300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAMBORGHINI TECHNOLOGIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies