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General NPI Number Information
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NPI Number | 1326405986
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Entity Type | Organization
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Legal Business Name | WODELA MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 7676 HILLMONT ST SUITE 240W
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City | HOUSTON
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State | TX
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Zip | 77040-6400
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Country | US
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Telephone | 832-680-0890
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Fax |
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Provider Business Mailing Address
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Address Line | 1906 STIELER DR
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City | HOUSTON
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State | TX
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Zip | 77049-1175
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Country | US
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Telephone | 214-477-2691
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KOSSIVI WODY EDJI
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Credential |
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Telephone | 214-477-2691
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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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