MEDICARE: ELETE TRANSPORTATION

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	343900000X	Non-emergency Medical Transport (VAN)	17302563	TX
2	347C00000X	Private Vehicle	17302563	TX

General Provider Information

NPI Number	:	1437435328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELETE TRANSPORTATION

Provider Business Mailing Address
First Line	:	6209 GRAPE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-7421
Country	:	US
Telephone Number	:	832-703-9491
Fax Number	:	281-974-4450

Provider Business Practice Location Address
First Line	:	6209 GRAPE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-7421
Country	:	US
Telephone Number	:	832-703-9491
Fax Number	:	281-974-4450

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DREYFUS LINDSEY
Credential	:
Telephone Number	:	83270394941

Provider Enumeration Date	:	10/24/2011
Last Update Date	:	10/24/2011

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Directions to “ELETE TRANSPORTATION ” Practice Location

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