Healthcare Provider Details

I. General information

NPI: 1588318091
Provider Name (Legal Business Name): THE BROOKS FAMILY TRANSPORTATION SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2022
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 TOWN CREEK DR
DALLAS TX
75232-1649
US

IV. Provider business mailing address

430 TOWN CREEK DR
DALLAS TX
75232-1649
US

V. Phone/Fax

Practice location:
  • Phone: 832-259-4572
  • Fax:
Mailing address:
  • Phone: 832-259-4572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. GARY W BROOKS
Title or Position: CEO
Credential:
Phone: 214-718-7346