Provider Demographics
NPI:1902503089
Name:TRAVEL WITH TIKI LLC
Entity type:Organization
Organization Name:TRAVEL WITH TIKI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICKA
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:MUSSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-701-3713
Mailing Address - Street 1:5817 KNOLL PINES PASS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78724-7503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5817 KNOLL PINES PASS
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78724-7503
Practice Address - Country:US
Practice Address - Phone:512-701-3713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)