Healthcare Provider Details

I. General information

NPI: 1982923827
Provider Name (Legal Business Name): LATOM E.M.S INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12808 W AIRPORT BLVD STE 348
SUGAR LAND TX
77478-6191
US

IV. Provider business mailing address

12808 W AIRPORT BLVD STE 348
SUGAR LAND TX
77478-6191
US

V. Phone/Fax

Practice location:
  • Phone: 832-338-9637
  • Fax:
Mailing address:
  • Phone: 832-338-9637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number013702
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: OMOLARA O DARAMOLA
Title or Position: OWNER
Credential:
Phone: 832-338-9637