MEDICARE: STAT RESPONSE MEDICAL TRANSIT

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)

General Provider Information

NPI Number	:	1225427735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAT RESPONSE MEDICAL TRANSIT

Provider Business Mailing Address
First Line	:	3821 WENTWORTH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-6509
Country	:	US
Telephone Number	:	832-665-3681
Fax Number	:

Provider Business Practice Location Address
First Line	:	3821 WENTWORTH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-6509
Country	:	US
Telephone Number	:	832-436-4133
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ROBETTE MUSE CARTER
Credential	:
Telephone Number	:	832-665-3681

Provider Enumeration Date	:	01/21/2015
Last Update Date	:	01/21/2015

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Directions to “STAT RESPONSE MEDICAL TRANSIT ” Practice Location

Language	Start Address	Practice Location

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