Organization
PAY A RIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY LEE JOHNSON (OWEN)
(254) 224-6802
Entity
Organization
Contact information
Practice address
600 LAKE AIR DR, SUITE 3A, WACO, TX 76710-5887
(254) 224-6208
Mailing address
600 LAKE AIR DR SUITE 3-A, WACO, TX 76712
(254) 224-6208
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
343900000
TX
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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