Healthcare Provider Details

I. General information

NPI: 1982199501
Provider Name (Legal Business Name): LTC TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9630 CLAREWOOD DR. A2
HOUSTON TX
77036
US

IV. Provider business mailing address

9630 CLAREWOOD DR. A2
HOUSTON TX
77036
US

V. Phone/Fax

Practice location:
  • Phone: 713-777-5123
  • Fax: 713-271-6689
Mailing address:
  • Phone: 713-777-5123
  • Fax: 713-271-6689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ZHUODAO ZHAO
Title or Position: OWNER/OPERATING MANAGER
Credential:
Phone: 713-777-5123