Provider Demographics
NPI:1982923827
Name:LATOM E.M.S INC
Entity type:Organization
Organization Name:LATOM E.M.S INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMOLARA
Authorized Official - Middle Name:O
Authorized Official - Last Name:DARAMOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-338-9637
Mailing Address - Street 1:12808 W AIRPORT BLVD STE 348
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6191
Mailing Address - Country:US
Mailing Address - Phone:832-338-9637
Mailing Address - Fax:
Practice Address - Street 1:12808 W AIRPORT BLVD STE 348
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6191
Practice Address - Country:US
Practice Address - Phone:832-338-9637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LATOM E.M.S INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-18
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013702251E00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherHOMEHEALTH
TX=========OtherHOMEHEALTH