Provider Demographics
NPI:1124768189
Name:MEDTRO HOUSTON LLC
Entity type:Organization
Organization Name:MEDTRO HOUSTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-657-8413
Mailing Address - Street 1:PO BOX 79721
Mailing Address - Street 2:PO BOX
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77279
Mailing Address - Country:US
Mailing Address - Phone:832-358-3694
Mailing Address - Fax:800-554-6826
Practice Address - Street 1:875 N ELDRIDGE PKWY APT 373
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2742
Practice Address - Country:US
Practice Address - Phone:817-657-8413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)