Provider Demographics
NPI:1487978342
Name:TEXAS MED SUPPORT LLC
Entity type:Organization
Organization Name:TEXAS MED SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:STOLP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-265-1431
Mailing Address - Street 1:10311 W AIRPORT BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2833
Mailing Address - Country:US
Mailing Address - Phone:832-265-1431
Mailing Address - Fax:281-499-0026
Practice Address - Street 1:10311 W AIRPORT BLVD
Practice Address - Street 2:SUITE111
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3344
Practice Address - Country:US
Practice Address - Phone:832-265-1431
Practice Address - Fax:281-499-0026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS MED SUPPORT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-22
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNOT YET ISSUED341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX271269485Medicare Oscar/Certification