MEDICARE: LA HOWARD MEDICAL 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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1710435789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA HOWARD MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	201 BEACH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-6915
Country	:	US
Telephone Number	:	817-838-3838
Fax Number	:	817-838-3737

Provider Business Practice Location Address
First Line	:	201 BEACH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-6915
Country	:	US
Telephone Number	:	817-838-3838
Fax Number	:	817-838-3737

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LUTFI ALI LUTFI
Credential	:
Telephone Number	:	817-838-3838

Provider Enumeration Date	:	09/19/2016
Last Update Date	:	09/19/2016

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