Provider Demographics
NPI:1326801549
Name:ANGEL WHEELS TX LLC
Entity Type:Organization
Organization Name:ANGEL WHEELS TX LLC
Other - Org Name:ANGEL WHEELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-519-7944
Mailing Address - Street 1:4001 N 54TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-4507
Mailing Address - Country:US
Mailing Address - Phone:678-644-0535
Mailing Address - Fax:
Practice Address - Street 1:4001 N 54TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-4507
Practice Address - Country:US
Practice Address - Phone:678-644-0535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGEL WHEELS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-31
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No342000000XTransportation ServicesTransportation Network Company
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi