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General NPI Number Information
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NPI Number | 1104719335
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Entity Type | Organization
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Legal Business Name | KVL MED TRANSPORT LLC
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1481 W 7TH ST APT 9
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City | UPLAND
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State | CA
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Zip | 91786-7058
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Country | US
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Telephone | 602-538-8334
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Fax |
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Provider Business Mailing Address
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Address Line | 12201 DERBY ROYAL DR
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City | HOUSTON
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State | TX
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Zip | 77044-2779
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Country | US
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Telephone | 802-503-9898
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | GABRIEL BRAXTON
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Credential |
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Telephone | 602-538-8334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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