Provider Demographics
NPI:1700634961
Name:TEXAS STATE TRANSPORTATION
Entity Type:Organization
Organization Name:TEXAS STATE TRANSPORTATION
Other - Org Name:TEXAS STATE TRANSPORTATION
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANNERING
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-229-3024
Mailing Address - Street 1:8426 BAY ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-1687
Mailing Address - Country:US
Mailing Address - Phone:346-229-3024
Mailing Address - Fax:
Practice Address - Street 1:8426 BAY ORCHARD DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-1687
Practice Address - Country:US
Practice Address - Phone:346-229-3024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)