# GOODM SAMARITAN RIDES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275361099
- **Authorized official:** DEREK CLARK ESTY (OWNER)
- **Authorized official phone:** (469) 585-4001

## Contact information

- **Practice address:** 180 CROWN COLONY DR, PROSPER, TX 75078-7045
- **Practice address phone:** (469) 585-4001
- **Mailing address:** 180 CROWN COLONY DR, PROSPER, TX 75078-7045
- **Mailing address phone:** (469) 585-4001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 343800000X | Secured Medical Transport (VAN) | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |
| 347C00000X | Private Vehicle | — | NULL | Yes |

## Other

- **Enumeration date:** 07/23/2024
- **Last updated:** 08/22/2024