Healthcare Provider Details

I. General information

NPI: 1083093694
Provider Name (Legal Business Name): HEART TO HEART PROVIDER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 N BECKLEY AVE
DALLAS TX
75203-1194
US

IV. Provider business mailing address

PO BOX 382781
DUNCANVILLE TX
75138-2781
US

V. Phone/Fax

Practice location:
  • Phone: 800-520-9072
  • Fax: 702-446-5164
Mailing address:
  • Phone: 800-520-9072
  • Fax: 702-446-5164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: LATOSHA S RIDER
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 214-714-1386