Healthcare Provider Details

I. General information

NPI: 1154076743
Provider Name (Legal Business Name): OASIS MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2022
Last Update Date: 02/13/2022
Certification Date: 02/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2104 REGENCY DR
IRVING TX
75062-4940
US

IV. Provider business mailing address

104 CONSTITUTION DR
EULESS TX
76040-4675
US

V. Phone/Fax

Practice location:
  • Phone: 469-487-0376
  • Fax:
Mailing address:
  • Phone: 469-487-0376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: ROSE MUKUNGA
Title or Position: MANAGER
Credential:
Phone: 469-487-0376