Provider Demographics
NPI:1770094203
Name:RM GONZALEZ TRANSPORTATION LLC
Entity type:Organization
Organization Name:RM GONZALEZ TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:ATILIO
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:210-995-3974
Mailing Address - Street 1:3710 ARANDA FLDS
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3543
Mailing Address - Country:US
Mailing Address - Phone:210-995-3974
Mailing Address - Fax:
Practice Address - Street 1:3710 ARANDA FLDS
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-3543
Practice Address - Country:US
Practice Address - Phone:210-995-3974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)