Healthcare Provider Details
I. General information
NPI: 1598583817
Provider Name (Legal Business Name): DOLLARHIDE INDUSTRIAL RESPONSE TEAM L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7457 HARWIN DR STE 327C
HOUSTON TX
77036-2027
US
IV. Provider business mailing address
PO BOX 542
BAYTOWN TX
77522-0542
US
V. Phone/Fax
- Phone: 832-205-8563
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 146L00000X |
| Taxonomy | Paramedic |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 146N00000X |
| Taxonomy | Basic Emergency Medical Technician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEMETRIUS
DOLLARHIDE
Title or Position: CHIEF EXECUTIVE OFFICE
Credential:
Phone: 832-205-8563