Provider Demographics
NPI:1679308704
Name:THERESAMP ENTERPRISE LLC
Entity type:Organization
Organization Name:THERESAMP ENTERPRISE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:726-233-9234
Mailing Address - Street 1:PO BOX 591343
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0116
Mailing Address - Country:US
Mailing Address - Phone:726-233-9234
Mailing Address - Fax:210-485-3890
Practice Address - Street 1:4518 SUMMER FALL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2057
Practice Address - Country:US
Practice Address - Phone:726-233-9234
Practice Address - Fax:210-485-3890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERESAMP ENTERPRISE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-06
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company