Healthcare Provider Details

I. General information

NPI: 1740960731
Provider Name (Legal Business Name): TX NEMT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7608 NOVELLA DR
FORT WORTH TX
76134-4319
US

IV. Provider business mailing address

7608 NOVELLA DR
FORT WORTH TX
76134-4319
US

V. Phone/Fax

Practice location:
  • Phone: 702-372-6089
  • Fax:
Mailing address:
  • Phone: 702-372-6089
  • 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: AHMED ABU SAMAKE
Title or Position: OWNER
Credential:
Phone: 702-372-6089