Provider Demographics
NPI:1639857634
Name:UNCLE SAM LLC
Entity Type:Organization
Organization Name:UNCLE SAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-873-5060
Mailing Address - Street 1:19715 STANFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-3209
Mailing Address - Country:US
Mailing Address - Phone:832-873-5060
Mailing Address - Fax:
Practice Address - Street 1:19715 STANFIELD CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-3209
Practice Address - Country:US
Practice Address - Phone:832-873-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker