Individual
MR. DEMETRIUS ISAAC SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4835 DOVE COVE LN, LEAGUE CITY, TX 77573-7505
(314) 807-0419
Mailing address
4835 DOVE COVE LN, LEAGUE CITY, TX 77573-7505
(314) 807-0419
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
07/15/2024
Last updated
10/16/2024
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