Healthcare Provider Details

I. General information

NPI: 1649590761
Provider Name (Legal Business Name): PEACE OF MIND TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5326 W BELLFORT ST STE 112
HOUSTON TX
77035-3031
US

IV. Provider business mailing address

PO BOX 376
FRESNO TX
77545-0376
US

V. Phone/Fax

Practice location:
  • Phone: 281-804-7504
  • Fax: 281-466-4430
Mailing address:
  • Phone: 281-804-7504
  • Fax: 281-466-4430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number01291094
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number01291094
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number01291094
License Number StateTX

VIII. Authorized Official

Name: MR. DANNA D EARLS
Title or Position: OWNER
Credential:
Phone: 281-804-7504