Provider Demographics
NPI:1124679113
Name:BK MED TRANS LLC
Entity type:Organization
Organization Name:BK MED TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KHEDIDJA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-494-6000
Mailing Address - Street 1:PO BOX 29157
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-0157
Mailing Address - Country:US
Mailing Address - Phone:210-494-6000
Mailing Address - Fax:210-783-8350
Practice Address - Street 1:5149 WURZBACH RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-2418
Practice Address - Country:US
Practice Address - Phone:210-494-6000
Practice Address - Fax:210-783-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-22
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4040735Medicaid