Provider Demographics
NPI:1063185585
Name:XTRA MATRIX GLOBAL SERVICES LLC
Entity type:Organization
Organization Name:XTRA MATRIX GLOBAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:OISEMAYE
Authorized Official - Last Name:IMOUKHUEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-497-6322
Mailing Address - Street 1:3944 ROCHELLE LN
Mailing Address - Street 2:
Mailing Address - City:HEARTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75126-2657
Mailing Address - Country:US
Mailing Address - Phone:832-497-6322
Mailing Address - Fax:
Practice Address - Street 1:3944 ROCHELLE LN
Practice Address - Street 2:
Practice Address - City:HEARTLAND
Practice Address - State:TX
Practice Address - Zip Code:75126-2657
Practice Address - Country:US
Practice Address - Phone:832-497-6322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)