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General NPI Number Information
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NPI Number | 1295109437
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Entity Type | Organization
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Legal Business Name | CYPRESS CREEK MEDICAL TRANSPORTATION LLC
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Dates
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Enumeration Date | 11/27/2015
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Last Update Date | 11/27/2015
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Provider Practice Location Address
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Address Line | 2611 CYPRESS CREEK PKWY F-102
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City | HOUSTON
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State | TX
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Zip | 77068-3731
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Country | US
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Telephone | 713-875-9776
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Fax | 281-973-0970
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Provider Business Mailing Address
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Address Line | 2611 CYPRESS CREEK PKWY F-102
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City | HOUSTON
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State | TX
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Zip | 77068-3731
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Country | US
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Telephone | 713-875-9776
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Fax | 281-973-0970
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Authorized Official
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Title or Position | MANAGER
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Name | RASAQ ADENIYI KOTUN
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Credential | DRIVER
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Telephone | 713-875-9776
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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 | 14373015
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License Number State | TX
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