MEDICARE: ELITE 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	:	1912394115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE TRANSIT

Provider Business Mailing Address
First Line	:	12455 WESTPARK DR STE G2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-5530
Country	:	US
Telephone Number	:	281-506-7508
Fax Number	:

Provider Business Practice Location Address
First Line	:	12455 WESTPARK DR STE G4
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-5530
Country	:	US
Telephone Number	:	281-506-7508
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CRYSTAL GARDNER
Credential	:
Telephone Number	:	281-506-7508

Provider Enumeration Date	:	04/25/2015
Last Update Date	:	04/27/2015

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Directions to “ELITE TRANSIT ” Practice Location

Language	Start Address	Practice Location

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