Provider Demographics
NPI:1285473090
Name:DECACORD
Entity type:Organization
Organization Name:DECACORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEBOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWASEGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-774-1036
Mailing Address - Street 1:14906 WESTPARK DR APT 3124
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-4980
Mailing Address - Country:US
Mailing Address - Phone:346-774-1036
Mailing Address - Fax:
Practice Address - Street 1:14906 WESTPARK DR APT 3124
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-4980
Practice Address - Country:US
Practice Address - Phone:346-774-1036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)