Provider Demographics
NPI:1336649763
Name:MATAG TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:MATAG TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AZHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSEEDAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-263-0514
Mailing Address - Street 1:4914 JARL CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-4875
Mailing Address - Country:US
Mailing Address - Phone:303-263-0514
Mailing Address - Fax:832-553-7818
Practice Address - Street 1:4914 JARL CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-4875
Practice Address - Country:US
Practice Address - Phone:303-263-0514
Practice Address - Fax:832-553-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)