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General NPI Number Information
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NPI Number | 1417171075
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Entity Type | Organization
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Legal Business Name | MEDPRO MEDICAL SERVICES INC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1425 HWY 75 N
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City | HUNTSVILLE
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State | TX
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Zip | 77320
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Country | US
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Telephone | 936-295-7665
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Fax | 936-295-5676
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Provider Business Mailing Address
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Address Line | PO BOX 807
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City | TRINITY
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State | TX
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Zip | 75862-0807
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Country | US
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Telephone | 936-295-7665
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Fax | 936-295-5676
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Authorized Official
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Title or Position | DIRECTOR
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Name | KEVIN TRAYLOR
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Credential |
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Telephone | 936-295-7665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 300257
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License Number State | TX
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