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General NPI Number Information
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NPI Number | 1942015268
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Entity Type | Organization
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Legal Business Name | M&D RELIABLE TRANSPORT
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 8802 OLMSTEAD PARK
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City | CONVERSE
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State | TX
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Zip | 78109
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Country | US
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Telephone | 480-262-2912
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 BROADWAY STE 240
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City | SAN ANTONIO
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State | TX
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Zip | 78209-6300
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Country | US
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Telephone | 480-262-2912
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAREL MARTIN BRAZELTON SR.
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Credential |
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Telephone | 480-262-2912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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