Healthcare Provider Details

I. General information

NPI: 1306520002
Provider Name (Legal Business Name): RESILIENT MEDICAL TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 TANGLEWILDE ST APT 243
HOUSTON TX
77063-2119
US

IV. Provider business mailing address

2501 TANGLEWILDE ST APT 243
HOUSTON TX
77063-2119
US

V. Phone/Fax

Practice location:
  • Phone: 281-451-5982
  • Fax:
Mailing address:
  • Phone: 281-451-5982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: KAFAY MOHAMED
Title or Position: OWNER
Credential:
Phone: 281-451-5982