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General NPI Number Information
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NPI Number | 1417334624
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Entity Type | Organization
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Legal Business Name | VICTORIAN MEDICAL TRANSPORT INC
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 1644 CEDAR BLUFF LN
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City | DALLAS
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State | TX
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Zip | 75253-4846
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Country | US
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Telephone | 972-379-8633
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Fax | 469-620-2370
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Provider Business Mailing Address
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Address Line | 1644 CEDAR BLUFF LN
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City | DALLAS
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State | TX
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Zip | 75253-4846
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Country | US
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Telephone | 972-379-8633
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Fax | 469-620-2370
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Authorized Official
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Title or Position | OWNER
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Name | VICTORIA LEWIS
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Credential |
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Telephone | 972-379-8633
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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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