Healthcare Provider Details

I. General information

NPI: 1104745314
Provider Name (Legal Business Name): PRORIDE MEDICAL TRANSIT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19901 SOUTHWEST FWY
SUGAR LAND TX
77479-6538
US

IV. Provider business mailing address

19901 SOUTHWEST FWY
SUGAR LAND TX
77479-6538
US

V. Phone/Fax

Practice location:
  • Phone: 757-288-6365
  • Fax:
Mailing address:
  • Phone: 757-288-6365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: TYRONE OBASEKI
Title or Position: CEO
Credential: LPC
Phone: 757-288-6365