Provider Demographics
NPI:1952012122
Name:1121 DREAM TRANSPORTATION
Entity Type:Organization
Organization Name:1121 DREAM TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LESTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-592-9861
Mailing Address - Street 1:4113 BLEVINS LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-0207
Mailing Address - Country:US
Mailing Address - Phone:678-592-9861
Mailing Address - Fax:
Practice Address - Street 1:4113 BLEVINS LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-0207
Practice Address - Country:US
Practice Address - Phone:678-592-9861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker