Provider Demographics
NPI:1740496934
Name:ELITE MEDICAL TRANSPORT OF TEXAS
Entity type:Organization
Organization Name:ELITE MEDICAL TRANSPORT OF TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LEEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-351-3224
Mailing Address - Street 1:PO BOX 12070
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-0070
Mailing Address - Country:US
Mailing Address - Phone:915-542-1194
Mailing Address - Fax:915-542-0706
Practice Address - Street 1:1000 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901
Practice Address - Country:US
Practice Address - Phone:915-542-1194
Practice Address - Fax:915-542-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000024341600000X
343800000X, 343900000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1881161-01Medicaid
TX1881161-01Medicaid