Provider Demographics
NPI:1063745685
Name:VICS TEXAS TRANSPORT INC
Entity type:Organization
Organization Name:VICS TEXAS TRANSPORT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:956-867-4284
Mailing Address - Street 1:4305 N 10TH ST STE J2
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2976
Mailing Address - Country:US
Mailing Address - Phone:956-867-4284
Mailing Address - Fax:956-205-2011
Practice Address - Street 1:4305 N 10TH ST STE J2
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2976
Practice Address - Country:US
Practice Address - Phone:956-867-4284
Practice Address - Fax:956-205-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10003163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport