Provider Demographics
NPI:1528314804
Name:DALLAS LIFECARE EMS ,LLC
Entity type:Organization
Organization Name:DALLAS LIFECARE EMS ,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINITRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THEOPHILUS
Authorized Official - Middle Name:CHIBUZOR
Authorized Official - Last Name:OZONOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-607-0344
Mailing Address - Street 1:3228 SOUTHERN DR
Mailing Address - Street 2:203A
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1579
Mailing Address - Country:US
Mailing Address - Phone:972-271-1105
Mailing Address - Fax:972-271-1125
Practice Address - Street 1:3228 SOUTHERN DR
Practice Address - Street 2:203A
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1579
Practice Address - Country:US
Practice Address - Phone:972-271-1105
Practice Address - Fax:972-271-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10008223416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport