Provider Demographics
NPI:1053973982
Name:BRAVO TRANSPORT SERVICES
Entity type:Organization
Organization Name:BRAVO TRANSPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMUEJEVOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-876-0306
Mailing Address - Street 1:806 CUSTER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:806 CUSTER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2256
Practice Address - Country:US
Practice Address - Phone:972-876-0306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)