MEDICARE: UNIQUE GRACE MEDICAL TRANSPORTATION

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	347E00000X	Transportation Broker

General Provider Information

NPI Number	:	1033597919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUE GRACE MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	14238 BEECH MEADOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5865
Country	:	US
Telephone Number	:	832-576-3966
Fax Number	:	281-495-9182

Provider Business Practice Location Address
First Line	:	14165 BISSONNET ST
Second Line	:	SUITE D
City	:	HOUSTON
State	:	TX
Zip	:	77083-6356
Country	:	US
Telephone Number	:	832-576-3966
Fax Number	:	281-495-9182

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. ADEDOKUN ADENIRAN
Credential	:
Telephone Number	:	832-576-3966

Provider Enumeration Date	:	05/12/2015
Last Update Date	:	09/16/2015

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Directions to “UNIQUE GRACE MEDICAL TRANSPORTATION ” Practice Location

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