Provider Demographics
NPI:1255732004
Name:CENTRAL TEXAS TRANSPORTAION
Entity type:Organization
Organization Name:CENTRAL TEXAS TRANSPORTAION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:SHAHWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-895-1115
Mailing Address - Street 1:6519 ITHACA FRST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1625
Mailing Address - Country:US
Mailing Address - Phone:732-895-1115
Mailing Address - Fax:210-568-4200
Practice Address - Street 1:6519 ITHACA FRST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-1625
Practice Address - Country:US
Practice Address - Phone:732-895-1115
Practice Address - Fax:210-568-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)