MEDICARE: PERRY'S HEALTH RIDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1669931937	OTHER	TX	MEDICAL TRANSPORTATION

General Provider Information

NPI Number	:	1023677721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERRY'S HEALTH RIDE

Provider Business Mailing Address
First Line	:	6162 BELDART ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77033-1212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6162 BELDART ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77033-1212
Country	:	US
Telephone Number	:	713-557-1539
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARLOS PERRY
Credential	:
Telephone Number	:	713-557-1539

Provider Enumeration Date	:	06/07/2019
Last Update Date	:	06/07/2019

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Directions to “PERRY'S HEALTH RIDE ” Practice Location

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