Healthcare Provider Details

I. General information

NPI: 1932964335
Provider Name (Legal Business Name): WE-REP-MED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11999 KATY FWY STE 150O
HOUSTON TX
77079-1629
US

IV. Provider business mailing address

11999 KATY FWY STE 150O
HOUSTON TX
77079-1629
US

V. Phone/Fax

Practice location:
  • Phone: 832-375-9400
  • Fax:
Mailing address:
  • Phone: 832-375-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: OYERINDE SAMUEL AKANDE
Title or Position: ADMINISTRATORS
Credential:
Phone: 832-375-9400