Provider Demographics
NPI:1124586110
Name:ADVANCE MOBILITY TRANSPORTATION
Entity Type:Organization
Organization Name:ADVANCE MOBILITY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-717-8940
Mailing Address - Street 1:19811 LINDENFIELD PL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6696
Mailing Address - Country:US
Mailing Address - Phone:281-717-8045
Mailing Address - Fax:281-769-1232
Practice Address - Street 1:19811 LINDENFIELD PL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6696
Practice Address - Country:US
Practice Address - Phone:281-717-8940
Practice Address - Fax:281-717-8940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)