Provider Demographics
NPI:1477921294
Name:CBJ EXPRESS
Entity Type:Organization
Organization Name:CBJ EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:BILLUPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-834-8736
Mailing Address - Street 1:13015 HIRAM CLARKE RD
Mailing Address - Street 2:A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-3204
Mailing Address - Country:US
Mailing Address - Phone:832-834-8736
Mailing Address - Fax:832-672-7882
Practice Address - Street 1:13015 HIRAM CLARKE RD
Practice Address - Street 2:A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-3204
Practice Address - Country:US
Practice Address - Phone:832-834-8736
Practice Address - Fax:832-672-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3484594Medicaid