=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982705323
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRIPLE EMS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 06/11/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9898 BISSONNET ST SUITE # 583
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77036-8270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-988-0802
-----------------------------------------------------
Fax | 713-988-8042
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9898 BISSONNET ST SUITE # 583
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77036-8270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-988-0802
-----------------------------------------------------
Fax | 713-988-8042
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MR. JEFFERY CARL RECTOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-988-0802
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 0087729
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 1000192
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------