Provider Demographics
NPI:1720762719
Name:LACASITA MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:LACASITA MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MERLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-355-3208
Mailing Address - Street 1:14815 WILLOW MOSS ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4546
Mailing Address - Country:US
Mailing Address - Phone:210-355-3208
Mailing Address - Fax:
Practice Address - Street 1:14815 WILLOW MOSS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4546
Practice Address - Country:US
Practice Address - Phone:210-355-3208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker