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General NPI Number Information
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NPI Number | 1164938270
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Entity Type | Organization
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Legal Business Name | TEAM MUSGROVE SPORTS AGENCY DBA ON TIME WITH CARE LOGISTICS
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Dates
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Enumeration Date | 12/27/2017
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Last Update Date | 12/27/2017
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Provider Practice Location Address
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Address Line | 3131 MCKINNEY AVE STE 600
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City | DALLAS
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State | TX
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Zip | 75204-2456
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Country | US
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Telephone | 972-900-3116
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 132274
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City | DALLAS
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State | TX
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Zip | 75313-2274
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Country | US
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Telephone | 972-900-3116
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Fax | 972-364-1235
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Authorized Official
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Title or Position | OWNER
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Name | WALTER MUSGROVE III
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Credential |
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Telephone | 972-900-3116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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