MEDICARE: SPHINX MEDICAL TRANSPORTATION , INC

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)
2	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1154083590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPHINX MEDICAL TRANSPORTATION , INC

Provider Business Mailing Address
First Line	:	4193 NACO PERRIN BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217
Country	:	US
Telephone Number	:	210-517-7605
Fax Number	:	361-239-5090

Provider Business Practice Location Address
First Line	:	4193 NACO PERRIN BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217
Country	:	US
Telephone Number	:	210-517-7605
Fax Number	:	361-239-5090

Authorized Official
Title or Position	:	OWNER
Name	:	ELSAYED TAHER ABDELFATTAH
Credential	:
Telephone Number	:	210-517-7605

Provider Enumeration Date	:	10/13/2021
Last Update Date	:	10/26/2022

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