Provider Demographics
NPI:1467612879
Name:LBJ TRANSPORTATION & COURIER SERVICES
Entity Type:Organization
Organization Name:LBJ TRANSPORTATION & COURIER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:ELIA
Authorized Official - Last Name:MONTELONGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-665-8308
Mailing Address - Street 1:2626 SOUTH LOOP WEST
Mailing Address - Street 2:SUITE 240B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054
Mailing Address - Country:US
Mailing Address - Phone:713-665-8308
Mailing Address - Fax:713-665-8349
Practice Address - Street 1:2626 SOUTH LOOP WEST
Practice Address - Street 2:SUITE 240B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-665-8308
Practice Address - Fax:713-665-8349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17249835172A00000X, 343900000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation BrokerGroup - Multi-Specialty