Provider Demographics
NPI:1548774201
Name:SUDACARE TRANSPORTATION
Entity Type:Organization
Organization Name:SUDACARE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDANT
Authorized Official - Prefix:MR
Authorized Official - First Name:GHANDI
Authorized Official - Middle Name:ISAMELDIN
Authorized Official - Last Name:MOHAHMED
Authorized Official - Suffix:VI
Authorized Official - Credentials:MD
Authorized Official - Phone:469-867-3670
Mailing Address - Street 1:777 S CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7411
Mailing Address - Country:US
Mailing Address - Phone:916-370-8901
Mailing Address - Fax:972-707-8312
Practice Address - Street 1:777 S CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-7411
Practice Address - Country:US
Practice Address - Phone:916-370-8901
Practice Address - Fax:972-707-8312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)