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NPI Code Detail

MEDICARE: OMNITRANSIT LLC

MEDICARE: OMNITRANSIT LLC
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
1261QM0850XAdult Mental Health Clinic/Center
2343900000XNon-emergency Medical Transport (VAN)TX
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1598141038
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMNITRANSIT LLC
Provider Business Mailing Address
First Line : 14625 CRYSTAL LAKE DR
Second Line :
City : LITTLE ELM
State : TX
Zip : 75068-2767
Country : US
Telephone Number : 469-247-1824
Fax Number :
Provider Business Practice Location Address
First Line : 1403 BIRDS FORT TRL
Second Line :
City : ARLINGTON
State : TX
Zip : 76005-1244
Country : US
Telephone Number : 469-247-1824
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : PAUL MUTABARUKA
Credential :
Telephone Number : 469-247-1824
Provider Enumeration Date : 08/06/2015
Last Update Date : 11/03/2023

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Directions to “OMNITRANSIT LLC ” Practice Location

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