Provider Demographics
NPI:1215006796
Name:RST UNIVERSAL, INC
Entity Type:Organization
Organization Name:RST UNIVERSAL, INC
Other - Org Name:PRO-STAT AMBULANCE SERVICE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAYZILL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-808-8595
Mailing Address - Street 1:PO BOX 58313
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8313
Mailing Address - Country:US
Mailing Address - Phone:713-738-8500
Mailing Address - Fax:713-738-8502
Practice Address - Street 1:3745 ALMEDA GENOA RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-3832
Practice Address - Country:US
Practice Address - Phone:713-738-8500
Practice Address - Fax:713-738-8502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101289341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000683501Medicaid
TX000683501Medicaid