MEDICARE: MEDCARE EMS LLC

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	1000520	TX

General Provider Information

NPI Number	:	1174832513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCARE EMS LLC

Provider Business Mailing Address
First Line	:	5999 W 34TH ST
Second Line	:	SUITE 108 C
City	:	HOUSTON
State	:	TX
Zip	:	77092-6412
Country	:	US
Telephone Number	:	713-686-8502
Fax Number	:	713-686-8503

Provider Business Practice Location Address
First Line	:	5999 W 34TH ST
Second Line	:	SUITE 108 C
City	:	HOUSTON
State	:	TX
Zip	:	77092-6412
Country	:	US
Telephone Number	:	713-686-8502
Fax Number	:	713-686-8503

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. IRIS GONZALEZ
Credential	:
Telephone Number	:	713-686-8502

Provider Enumeration Date	:	10/04/2010
Last Update Date	:	12/30/2010

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