MEDICARE: VILLAGE FIRE DEPARTMENT

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	101056	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	509861	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	602915500	OTHER		US DOL PROVIDER ID
2	509861	OTHER	TX	BC/BS OF TEXAS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184643330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE FIRE DEPARTMENT

Provider Business Mailing Address
First Line	:	901 CORBINDALE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2805
Country	:	US
Telephone Number	:	713-468-7941
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 CORBINDALE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2805
Country	:	US
Telephone Number	:	713-468-7941
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARLO CONTRERAS-LONGORIA
Credential	:
Telephone Number	:	713-468-7941

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/25/2023

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Directions to “VILLAGE FIRE DEPARTMENT ” Practice Location

Language	Start Address	Practice Location

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