Provider Demographics
NPI:1467958132
Name:HOUSTON MOBILITY RIDE LLC
Entity Type:Organization
Organization Name:HOUSTON MOBILITY RIDE LLC
Other - Org Name:HOUSTON MOBILITY RIBE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUTROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-898-7337
Mailing Address - Street 1:7631 MCCORMICK MILL CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-4094
Mailing Address - Country:US
Mailing Address - Phone:832-898-7337
Mailing Address - Fax:
Practice Address - Street 1:7631 MCCORMICK MILL CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-4094
Practice Address - Country:US
Practice Address - Phone:832-898-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)