Provider Demographics
NPI:1598141962
Name:HAVILLA MEDICAL TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:HAVILLA MEDICAL TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FEMI
Authorized Official - Middle Name:RABIU
Authorized Official - Last Name:OKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-300-5245
Mailing Address - Street 1:13433 GARDEN GRV
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3411
Mailing Address - Country:US
Mailing Address - Phone:281-413-0629
Mailing Address - Fax:
Practice Address - Street 1:13433 GARDEN GROVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082
Practice Address - Country:US
Practice Address - Phone:281-413-0629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)