Provider Demographics
NPI:1629753017
Name:MKYAS TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MKYAS TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FIYORI
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-724-1899
Mailing Address - Street 1:8401 SKILLMAN ST APT 2073
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-1808
Mailing Address - Country:US
Mailing Address - Phone:210-724-1899
Mailing Address - Fax:
Practice Address - Street 1:8401 SKILLMAN ST APT 2073
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-1808
Practice Address - Country:US
Practice Address - Phone:210-724-1899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)