MEDICARE: DATHAN ASHER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance
2	341600000X	Ambulance	1000546	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1000546	OTHER	TX	TDSHS

General Provider Information

NPI Number	:	1255639589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DATHAN ASHER INC

Provider Business Mailing Address
First Line	:	17300 EL CAMINO REAL
Second Line	:	SUITE 110C
City	:	HOUSTON
State	:	TX
Zip	:	77058-2715
Country	:	US
Telephone Number	:	281-506-2808
Fax Number	:	866-602-5210

Provider Business Practice Location Address
First Line	:	17300 EL CAMINO REAL
Second Line	:	SUITE 110C
City	:	HOUSTON
State	:	TX
Zip	:	77058-2715
Country	:	US
Telephone Number	:	281-506-2808
Fax Number	:	866-602-5210

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL SELEXMAN
Credential	:
Telephone Number	:	281-570-3604

Provider Enumeration Date	:	03/10/2011
Last Update Date	:	03/10/2011

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Directions to “DATHAN ASHER INC ” Practice Location

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