Provider Demographics
NPI:1528058724
Name:KAM SYD LTD
Entity type:Organization
Organization Name:KAM SYD LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:281-422-7200
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-0119
Mailing Address - Country:US
Mailing Address - Phone:281-422-7200
Mailing Address - Fax:281-422-1999
Practice Address - Street 1:3103 N HIGHWAY 146
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-2669
Practice Address - Country:US
Practice Address - Phone:281-422-7200
Practice Address - Fax:281-422-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1012543416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143836801Medicaid
TX107257Medicare UPIN
TXAMB157Medicare ID - Type UnspecifiedPROVIDER NUMBER
TXAMB595Medicare UPIN