Mavstar Medical Transportation, Inc.

Primary specialty

Secured Medical Transport (VAN)Taxonomy code 343800000X

Legal business name

MAVSTAR MEDICAL TRANSPORTATION, INC.

Doing business as

Maverick Medical Transportation Company

Practice address

1612 S Broadway, Building 2, Ste. 200
Carrolton, TX 75006

Phone

(469) 892-0024

NPI assigned

Oct 18, 2023

Last updated

Nov 8, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Soon Burnam

Title

Treasurer

Phone

(949) 540-1249

Specialties & licenses 2

Addresses

Other names 1

• Maverick Medical Transportation Company Doing business as

Tax ID family

Maverick Medical Transportation Company2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mavstar Medical Transportation, Inc.

  dba Maverick Medical Transportation Company

  • Non-emergency Medical Transport (VAN)
  • Carrollton, TX
  • NPI 1073003869
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1215719869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 S. BROADWAY, BLDG. 2, SUITE 200",
            "city": "CARROLTON",
            "state": "TX",
            "postal_code": "75006",
            "telephone_number": "469-892-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 S BROADWAY, BUILDING 2, STE. 200",
            "city": "CARROLTON",
            "state": "TX",
            "postal_code": "75006",
            "telephone_number": "469-892-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVSTAR MEDICAL TRANSPORTATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maverick Medical Transportation Company",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maverick Medical Transportation Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Secured Medical Transport (VAN) in Carrolton, TX
• Providers in Carrolton, TX by specialty
• Secured Medical Transport (VAN) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.