Organization
WS TRANSPORTATION
Active
Other names
NEMT Driver
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE SMITH II (OWNER)
(817) 704-9583
Entity
Organization
Contact information
Practice address
1612 CHACON CANYON DR, DESOTO, TX 75115-7782
(817) 704-9583
Mailing address
1612 CHACON CANYON DR, DESOTO, TX 75115-7782
(817) 704-9583
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
343800000X
Secured Medical Transport (VAN)
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154149771
—
TX
Enumeration date
10/14/2024
Last updated
10/23/2024
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