1023484086 NPI number — 2PICK-A-RIDE

Table of content: (NPI 1023484086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023484086 NPI number — 2PICK-A-RIDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
2PICK-A-RIDE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023484086
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 394
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALENA PARK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77547-0394
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-362-6063
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2102 SAM WILSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77020-4456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-362-6063
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/13/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HENLEY
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
DENESE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
832-362-6063

Provider Taxonomy Codes

  • Taxonomy code: 347C00000X , with the licence number:  13751852 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 13751852 . This is a "TEXAS DRIVER LIC." identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".