Healthcare Provider Details

I. General information

NPI: 1649400151
Provider Name (Legal Business Name): VIC EMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 COMMERCE PARK DR 228G
HOUSTON TX
77036-7497
US

IV. Provider business mailing address

8700 COMMERCE PARK DR 228G
HOUSTON TX
77036-7497
US

V. Phone/Fax

Practice location:
  • Phone: 713-771-5088
  • Fax: 713-771-5096
Mailing address:
  • Phone: 713-771-5088
  • Fax: 713-771-5096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416S0300X
TaxonomyWater Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. VICTORIA OHANAKA
Title or Position: PRESIDENT
Credential:
Phone: 713-771-5088