Healthcare Provider Details

I. General information

NPI: 1225801426
Provider Name (Legal Business Name): E J MOORE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 TUMBLEWEED DR
CROSS ROADS TX
76227-3887
US

IV. Provider business mailing address

8600 TUMBLEWEED DR
CROSS ROADS TX
76227-3887
US

V. Phone/Fax

Practice location:
  • Phone: 469-825-1952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: HENRY MOORE
Title or Position: OWNER
Credential:
Phone: 469-825-1952