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General NPI Number Information
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NPI Number | 1740849934
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Entity Type | Organization
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Legal Business Name | D RIDE
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1400 LONGHORN TRL
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City | CROWLEY
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State | TX
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Zip | 76036-4760
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Country | US
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Telephone | 817-297-1983
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 LODESTONE LN
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City | FORT WORTH
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State | TX
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Zip | 76123-1873
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Country | US
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Telephone | 817-343-1983
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Fax |
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Authorized Official
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Title or Position | TRANSPORTATION
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Name | MR. DIEA CHAB KALEIA
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Credential |
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Telephone | 817-343-1983
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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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