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NPI Code Detail

MEDICARE: LGTIM & LIV TRANSPORTATION

MEDICARE: LGTIM & LIV 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
1172A00000XDriver

General Provider Information

NPI Number : 1083365118
Entity Type Code : Organization
Provider Name (Legal Business Name) : LGTIM & LIV TRANSPORTATION
Provider Business Mailing Address
First Line : 6407 LAURA KOPPE ROAD
Second Line :
City : HOUSTON
State : TX
Zip : 77016
Country : US
Telephone Number : 832-670-1774
Fax Number :
Provider Business Practice Location Address
First Line : 6407 LAURA KOPPE ROAD
Second Line :
City : HOUSTON
State : TX
Zip : 77016
Country : US
Telephone Number : 832-670-1774
Fax Number :
Authorized Official
Title or Position : COO
Name : EMMANUEL EARL BEAL
Credential :
Telephone Number : 832-670-1774
Provider Enumeration Date : 01/11/2022
Last Update Date : 01/11/2022

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Directions to “LGTIM & LIV TRANSPORTATION ” Practice Location

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