Healthcare Provider Details

I. General information

NPI: 1104540475
Provider Name (Legal Business Name): 1 CALL NON-EMERGENCY TRANSPORTATION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12704 BRUCE DR
BALCH SPRINGS TX
75180-5301
US

IV. Provider business mailing address

12704 BRUCE DR
BALCH SPRINGS TX
75180-5301
US

V. Phone/Fax

Practice location:
  • Phone: 469-774-7483
  • Fax:
Mailing address:
  • Phone: 469-774-7483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: RAY A ROUGEAUX
Title or Position: OWNER
Credential:
Phone: 469-774-7483