Provider Demographics
NPI:1609199009
Name:GOOD SHEPHERD EMS INC
Entity Type:Organization
Organization Name:GOOD SHEPHERD EMS INC
Other - Org Name:GOOD SHEPHERD EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:UCHE
Authorized Official - Last Name:ONYEKWELU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-748-2124
Mailing Address - Street 1:PO BOX 36131
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77236-6131
Mailing Address - Country:US
Mailing Address - Phone:832-830-8793
Mailing Address - Fax:832-242-2274
Practice Address - Street 1:6610 HARWIN DR
Practice Address - Street 2:218
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2232
Practice Address - Country:US
Practice Address - Phone:832-748-2124
Practice Address - Fax:832-242-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000480OtherTDSHS
TX2147076Medicaid
TX2147076Medicaid