Provider Demographics
NPI:1902415565
Name:AUGUST, MICHAEL JR
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:AUGUST
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3187 GIANNA SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-3094
Mailing Address - Country:US
Mailing Address - Phone:713-979-6134
Mailing Address - Fax:
Practice Address - Street 1:3187 GIANNA SPRINGS CT
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-3094
Practice Address - Country:US
Practice Address - Phone:713-979-6134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26163261343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)