Healthcare Provider Details

I. General information

NPI: 1902542400
Provider Name (Legal Business Name): G NEVELS TRANSPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2022
Last Update Date: 05/07/2022
Certification Date: 05/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 SKYLARK DR
TEXARKANA TX
75503-0043
US

IV. Provider business mailing address

701 N OATS ST APT 313
TEXARKANA AR
71854-5722
US

V. Phone/Fax

Practice location:
  • Phone: 903-691-5722
  • Fax:
Mailing address:
  • Phone: 903-691-5722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: GREGORY NEVELS
Title or Position: CEO
Credential:
Phone: 903-691-5722