MEDICARE: PRIORITY AMBULANCE SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	800093	TX

General Provider Information

NPI Number	:	1063448116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIORITY AMBULANCE SERVICE

Provider Business Mailing Address
First Line	:	6606 DE MOSS DR
Second Line	:	SUITE 108
City	:	HOUSTON
State	:	TX
Zip	:	77074-5000
Country	:	US
Telephone Number	:	713-291-1100
Fax Number	:	281-575-9602

Provider Business Practice Location Address
First Line	:	6606 DE MOSS DR
Second Line	:	SUITE 108
City	:	HOUSTON
State	:	TX
Zip	:	77074-5000
Country	:	US
Telephone Number	:	713-291-1100
Fax Number	:	281-575-9602

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ELMOTHANA WAQIALLA
Credential	:
Telephone Number	:	713-291-1100

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	08/22/2020

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Directions to “PRIORITY AMBULANCE SERVICE ” Practice Location

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