Provider Demographics
NPI:1619279494
Name:MEDXPRESS TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:MEDXPRESS TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERRY
Authorized Official - Middle Name:RANDLE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-423-8629
Mailing Address - Street 1:3101 WOODLARK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-1014
Mailing Address - Country:US
Mailing Address - Phone:817-423-8629
Mailing Address - Fax:817-704-4354
Practice Address - Street 1:3101 WOODLARK DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-1014
Practice Address - Country:US
Practice Address - Phone:817-423-8629
Practice Address - Fax:817-704-4354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXA210016198343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)