Provider Demographics
NPI:1366052268
Name:ABBY'S PROMISE TRANSPORTATION
Entity type:Organization
Organization Name:ABBY'S PROMISE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-302-4779
Mailing Address - Street 1:11486 STILL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8625
Mailing Address - Country:US
Mailing Address - Phone:225-302-4779
Mailing Address - Fax:
Practice Address - Street 1:13612 MIDWAY RD STE 333-15
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4308
Practice Address - Country:US
Practice Address - Phone:800-474-1388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)