Provider Demographics
NPI:1497056014
Name:CARDIOMAX EMS
Entity Type:Organization
Organization Name:CARDIOMAX EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:OKOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-295-9070
Mailing Address - Street 1:8700 COMMERCE PARK DR
Mailing Address - Street 2:STE 218H
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7431
Mailing Address - Country:US
Mailing Address - Phone:832-295-9070
Mailing Address - Fax:
Practice Address - Street 1:8700 COMMERCE PARK DR
Practice Address - Street 2:STE 218H
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7431
Practice Address - Country:US
Practice Address - Phone:832-295-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10005143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport