Provider Demographics
NPI:1215760681
Name:FRONTERA MEDIVAN TRANSPORTATION LLC
Entity type:Organization
Organization Name:FRONTERA MEDIVAN TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CADENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-251-6158
Mailing Address - Street 1:3902 AGUANIEVE DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-8117
Mailing Address - Country:US
Mailing Address - Phone:956-251-6158
Mailing Address - Fax:
Practice Address - Street 1:3902 AGUANIEVE DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-8117
Practice Address - Country:US
Practice Address - Phone:956-251-6158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker