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General NPI Number Information
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NPI Number | 1679949697
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Entity Type | Individual
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Provider Name | MICHELLE LADAWN DANIELS OFFICE MANGER/OWNER
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Gender | Female
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Dates
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Enumeration Date | 08/13/2015
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 16124 SE COUNTY ROAD 2375
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City | STREETMAN
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State | TX
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Zip | 75859-7148
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Country | US
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Telephone | 903-288-7084
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Fax | 903-599-2798
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Provider Business Mailing Address
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Address Line | 16124 SE CR 2375
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City | STREETMAN
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State | TX
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Zip | 75859
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Country | US
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Telephone | 903-288-7084
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Fax | 903-599-2798
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 472731403
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License Number State | TX
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