MEDICARE: AMAZING GRACE EMS, INC

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	341600000X	Ambulance	1000893	TX

General Provider Information

NPI Number	:	1235377417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAZING GRACE EMS, INC

Provider Business Mailing Address
First Line	:	8633 W AIRPORT BLVD
Second Line	:	STE 1026
City	:	HOUSTON
State	:	TX
Zip	:	77071-2479
Country	:	US
Telephone Number	:	832-880-8689
Fax Number	:	888-399-3556

Provider Business Practice Location Address
First Line	:	8633 W AIRPORT BLVD
Second Line	:	STE 1026
City	:	HOUSTON
State	:	TX
Zip	:	77071-2479
Country	:	US
Telephone Number	:	832-880-8689
Fax Number	:	888-399-3556

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. JOYCE WHITE
Credential	:
Telephone Number	:	832-880-8689

Provider Enumeration Date	:	01/27/2009
Last Update Date	:	05/26/2013

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Directions to “AMAZING GRACE EMS, INC ” Practice Location

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