Provider Demographics
NPI:1174993141
Name:GADO MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:GADO MEDICAL TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDISAID
Authorized Official - Middle Name:SULDAN
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:SR
Authorized Official - Credentials:ABDISAID
Authorized Official - Phone:832-209-0360
Mailing Address - Street 1:12720 BRANT ROCK DR APT 2402
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082
Mailing Address - Country:US
Mailing Address - Phone:832-209-0360
Mailing Address - Fax:832-209-0360
Practice Address - Street 1:12720 BRANT ROCK DR APT 2402
Practice Address - Street 2:12720 BRANT ROCK DR #2402
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5440
Practice Address - Country:US
Practice Address - Phone:832-209-0360
Practice Address - Fax:832-209-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)