Healthcare Provider Details

I. General information

NPI: 1699890319
Provider Name (Legal Business Name): DYNAMIC AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9898 BISSONNET ST SUITE 284
HOUSTON TX
77036-8270
US

IV. Provider business mailing address

9898 BISSONNET ST SUITE 284
HOUSTON TX
77036-8270
US

V. Phone/Fax

Practice location:
  • Phone: 281-575-9473
  • Fax: 713-271-7120
Mailing address:
  • Phone: 281-575-9473
  • Fax: 713-271-7120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number800051
License Number StateTX

VIII. Authorized Official

Name: CHIKITA THOMAS
Title or Position: OFFICE MANAGER
Credential:
Phone: 281-575-9473