Healthcare Provider Details

I. General information

NPI: 1346943024
Provider Name (Legal Business Name): DEBOSE ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7145 READING RD APT 1211
ROSENBERG TX
77471-6348
US

IV. Provider business mailing address

435 MURPHY RD STE B1
STAFFORD TX
77477-5420
US

V. Phone/Fax

Practice location:
  • Phone: 832-242-7194
  • Fax:
Mailing address:
  • Phone: 832-243-7194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHARONDA DEBOSE
Title or Position: EXECUTIVE DIRECTOR/OWNER
Credential:
Phone: 832-243-7194