MEDICARE: DL'S TRANSPORTATION SERVICE

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)	52825721	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386030096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DL'S TRANSPORTATION SERVICE

Provider Business Mailing Address
First Line	:	1866 COURTSIDE PLACE DR.
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489
Country	:	US
Telephone Number	:	713-998-6162
Fax Number	:

Provider Business Practice Location Address
First Line	:	1866 COURTSIDE PLACE DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-4026
Country	:	US
Telephone Number	:	713-998-6162
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANNY ROBERSON
Credential	:
Telephone Number	:	832-651-6268

Provider Enumeration Date	:	04/09/2015
Last Update Date	:	04/09/2015

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