Healthcare Provider Details

I. General information

NPI: 1982910493
Provider Name (Legal Business Name): G-WASA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 12/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 RICHMOND AVE STE. 121
HOUSTON TX
77042-4925
US

IV. Provider business mailing address

10700 RICHMOND AVE STE. 121
HOUSTON TX
77042-4925
US

V. Phone/Fax

Practice location:
  • Phone: 713-785-9362
  • Fax: 713-785-5081
Mailing address:
  • Phone: 713-785-9362
  • Fax: 713-785-5081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateTX

VIII. Authorized Official

Name: MS. SHERRY ANNE ATKINSON-LIVELY
Title or Position: CEO/OWNER
Credential:
Phone: 713-785-9362