MEDICARE: YOUR TIME MATTERS TRANSPORT SERVICES

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	:	1275906448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR TIME MATTERS TRANSPORT SERVICES

Provider Business Mailing Address
First Line	:	6411 SLATE STONE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1223
Country	:	US
Telephone Number	:	713-499-9292
Fax Number	:

Provider Business Practice Location Address
First Line	:	6411 SLATE STONE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1223
Country	:	US
Telephone Number	:	713-499-9292
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHEAL D HARRELL
Credential	:
Telephone Number	:	713-499-9292

Provider Enumeration Date	:	11/10/2015
Last Update Date	:	11/10/2015

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