Provider Demographics
NPI:1497158265
Name:EDWARDSTRANSPORT
Entity Type:Organization
Organization Name:EDWARDSTRANSPORT
Other - Org Name:EDWARDSTRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOTSHA
Authorized Official - Middle Name:KAWANA
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-780-8850
Mailing Address - Street 1:6814 BRIGHTON HILL LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6906
Mailing Address - Country:US
Mailing Address - Phone:281-780-8850
Mailing Address - Fax:
Practice Address - Street 1:6814 BRIGHTON HILL LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6906
Practice Address - Country:US
Practice Address - Phone:281-780-8850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle