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General NPI Number Information
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NPI Number | 1841918067
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Entity Type | Organization
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Legal Business Name | SILVER RIDERS TRANS LLC
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 14610 BROADBURY POND RD
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City | ROSHARON
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State | TX
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Zip | 77583-3902
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Country | US
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Telephone | 832-892-3013
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 782
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City | FRESNO
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State | TX
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Zip | 77545-0782
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Country | US
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Telephone | 346-552-2492
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. PAMELA CLARK
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Credential |
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Telephone | 832-819-0241
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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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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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