=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700860863
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOUSTON MEDICAL TRANSFER SERVICE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2005
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8525 STELLA LINK RD
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77025-2938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-349-0318
-----------------------------------------------------
Fax | 832-550-2640
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7761
-----------------------------------------------------
City | THE WOODLANDS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77387-7761
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-298-9440
-----------------------------------------------------
Fax | 832-550-2640
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JOE DAVIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-298-9440
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 101160
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------