Provider Demographics
NPI:1356616387
Name:BRAI MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:BRAI MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:IMOAGENE
Authorized Official - Last Name:AYONOTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-794-6297
Mailing Address - Street 1:6316 DRYAD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-6605
Mailing Address - Country:US
Mailing Address - Phone:832-794-6297
Mailing Address - Fax:
Practice Address - Street 1:6316 DRYAD DR,
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035
Practice Address - Country:US
Practice Address - Phone:832-794-6297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRAI INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801546132343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)