Healthcare Provider Details

I. General information

NPI: 1932561248
Provider Name (Legal Business Name): HEALTHSOURCE MEDICAL RESPONSE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18207 N ELDRIDGE PKWY STE A1
TOMBALL TX
77377-8169
US

IV. Provider business mailing address

PO BOX 1031
SEALY TX
77474-1031
US

V. Phone/Fax

Practice location:
  • Phone: 281-202-1356
  • Fax:
Mailing address:
  • Phone: 281-202-1356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateNULL

VIII. Authorized Official

Name: NDIDI OKORO
Title or Position: DIRECTOR
Credential:
Phone: 281-202-1356