1578098687 NPI number — SATX GUARDIAN TRANSPORTATION LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578098687 NPI number — SATX GUARDIAN TRANSPORTATION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SATX GUARDIAN TRANSPORTATION LLC
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:
1578098687
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4206 VALLEY PIKE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78230-1706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-931-1279
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
276 WINDMILL RANCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING BRANCH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-931-1279
Provider Business Practice Location Address Fax Number:
833-790-2064
Provider Enumeration Date:
04/26/2017

Additional Information

Authorized Official

Authorized Official Last Name:
GUERRA
Authorized Official First Name:
RICARDO
Authorized Official Middle Name:
SUAREZ
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
210-931-1279

Provider Taxonomy Codes

  • Taxonomy code: 343800000X , 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)





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