1417701327 NPI number — GOD MADE A WAY RELIABLE TRANSPORTATION

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 1417701327 NPI number — GOD MADE A WAY RELIABLE TRANSPORTATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOD MADE A WAY RELIABLE TRANSPORTATION
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:
6
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:
1417701327
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 HIGHWAY 90 W APT 408
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEALY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77474-4015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-924-8020
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 HIGHWAY 90 W APT 408
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEALY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77474-4015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-924-8020
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/16/2024

Additional Information

Authorized Official

Authorized Official Last Name:
CALLUM
Authorized Official First Name:
LATARSHA
Authorized Official Middle Name:
LATRICE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
713-924-8020

Provider Taxonomy Codes

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

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





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