Provider Demographics
NPI:1740001635
Name:IN HIS IMAGE TRANSPORTATION SERVICES LLC
Entity type:Organization
Organization Name:IN HIS IMAGE TRANSPORTATION SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-503-1006
Mailing Address - Street 1:20343 FOSSIL VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5181
Mailing Address - Country:US
Mailing Address - Phone:832-289-1066
Mailing Address - Fax:
Practice Address - Street 1:20343 FOSSIL VALLEY LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5181
Practice Address - Country:US
Practice Address - Phone:832-289-1066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)