Provider Demographics
NPI:1295218352
Name:CONVENIENT MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:CONVENIENT MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NDUKA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-868-7871
Mailing Address - Street 1:1014 WARM SUMMER DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2731
Mailing Address - Country:US
Mailing Address - Phone:713-480-6382
Mailing Address - Fax:
Practice Address - Street 1:1014 WARM SUMMER DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2731
Practice Address - Country:US
Practice Address - Phone:713-480-6382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)