Healthcare Provider Details

I. General information

NPI: 1619796257
Provider Name (Legal Business Name): 910 TRANSPORT LIMITED LIBITITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2923 COLIMA ST
SAN ANTONIO TX
78207-5708
US

IV. Provider business mailing address

2923 COLIMA ST
SAN ANTONIO TX
78207-5708
US

V. Phone/Fax

Practice location:
  • Phone: 210-992-0014
  • Fax:
Mailing address:
  • Phone: 210-992-0014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY HOUSTON
Title or Position: OWNER
Credential:
Phone: 210-992-0014