Provider Demographics
NPI:1376070474
Name:TRAVELING GRACE NON EMERGENCY MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:TRAVELING GRACE NON EMERGENCY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-609-3486
Mailing Address - Street 1:PO BOX 841202
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0001
Mailing Address - Country:US
Mailing Address - Phone:713-609-3486
Mailing Address - Fax:
Practice Address - Street 1:2920 OAK RD APT 1009
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8819
Practice Address - Country:US
Practice Address - Phone:713-609-3486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)