Healthcare Provider Details

I. General information

NPI: 1770070005
Provider Name (Legal Business Name): LYFEONWHEELS MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 MILLER RANCH RD
PEARLAND TX
77584-9725
US

IV. Provider business mailing address

7402 BLUE GAP
MISSOURI CITY TX
77459-6888
US

V. Phone/Fax

Practice location:
  • Phone: 281-954-5000
  • Fax:
Mailing address:
  • Phone: 832-283-8978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. ASHA MATHEW
Title or Position: OWNER
Credential: RN
Phone: 832-283-8978