Provider Demographics
NPI:1861177594
Name:TITAN AUTO GROUP
Entity type:Organization
Organization Name:TITAN AUTO GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:ULIRICA
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-607-6626
Mailing Address - Street 1:508 E PLEASANT RUN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1750
Mailing Address - Country:US
Mailing Address - Phone:972-607-6626
Mailing Address - Fax:
Practice Address - Street 1:508 E PLEASANT RUN RD STE 202
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1750
Practice Address - Country:US
Practice Address - Phone:972-607-6626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle