Provider Demographics
NPI:1972188357
Name:CENTRAL TEXAS MEDTRANS, LLC
Entity Type:Organization
Organization Name:CENTRAL TEXAS MEDTRANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIR
Authorized Official - Suffix:
Authorized Official - Credentials:BUSINESS OWNER NEMT
Authorized Official - Phone:254-295-0612
Mailing Address - Street 1:3906 TRINITY DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-4944
Mailing Address - Country:US
Mailing Address - Phone:951-286-7581
Mailing Address - Fax:
Practice Address - Street 1:1205 W AVENUE G
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-5308
Practice Address - Country:US
Practice Address - Phone:254-294-9009
Practice Address - Fax:254-295-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)