Provider Demographics
NPI:1659559623
Name:TRANS-STAR MEDICAL TRANSPORT INC.
Entity Type:Organization
Organization Name:TRANS-STAR MEDICAL TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEMIKA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-432-4444
Mailing Address - Street 1:6046 FM 2920 RD # 203
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2542
Mailing Address - Country:US
Mailing Address - Phone:210-432-4444
Mailing Address - Fax:
Practice Address - Street 1:6323 SOVEREIGN ST STE 288
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5132
Practice Address - Country:US
Practice Address - Phone:210-432-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000104341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1945321-01Medicaid