Healthcare Provider Details

I. General information

NPI: 1770469736
Provider Name (Legal Business Name): SOUTHERN CONCIERGE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 WESTRIDGE RD
SPRING TX
77380-2844
US

IV. Provider business mailing address

1103 LYNWOOD RD
SPRING TX
77373-5631
US

V. Phone/Fax

Practice location:
  • Phone: 713-865-0254
  • Fax: 866-434-1073
Mailing address:
  • Phone: 713-865-0254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: RACHEL JELKS
Title or Position: DIRECTOR
Credential:
Phone: 713-865-0254