Provider Demographics
NPI:1073884672
Name:UNIQUE PERSONAL CARE TRANSPORTATION
Entity Type:Organization
Organization Name:UNIQUE PERSONAL CARE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:TENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-225-8596
Mailing Address - Street 1:3865 BRYAN DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2428
Mailing Address - Country:US
Mailing Address - Phone:409-225-8596
Mailing Address - Fax:409-832-0408
Practice Address - Street 1:3865 BRYAN DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2428
Practice Address - Country:US
Practice Address - Phone:409-225-8596
Practice Address - Fax:409-832-0408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09286129347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle