MEDICARE: THE DYNAMIC TRANIST SERVICES LLC

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	:	1780344317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DYNAMIC TRANIST SERVICES LLC

Provider Business Mailing Address
First Line	:	18326 MANORCLIFF LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-2744
Country	:	US
Telephone Number	:	832-850-0447
Fax Number	:

Provider Business Practice Location Address
First Line	:	2717 COMMERCIAL CENTER BLVD ST E200
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-7749
Country	:	US
Telephone Number	:	832-850-0447
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ASHELEY LAKEYA GILBERT
Credential	:
Telephone Number	:	832-850-0447

Provider Enumeration Date	:	12/22/2021
Last Update Date	:	12/22/2021

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