MEDICARE: ALL TEXAS AMBULANCE, 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		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295720324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL TEXAS AMBULANCE, INC.

Provider Business Mailing Address
First Line	:	5645 HILLCROFT ST
Second Line	:	801
City	:	HOUSTON
State	:	TX
Zip	:	77036-2296
Country	:	US
Telephone Number	:	713-244-9992
Fax Number	:	713-224-9975

Provider Business Practice Location Address
First Line	:	5645 HILLCROFT ST
Second Line	:	801
City	:	HOUSTON
State	:	TX
Zip	:	77036-2296
Country	:	US
Telephone Number	:	713-244-9992
Fax Number	:	713-224-9975

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DERRICK TILLMAN
Credential	:
Telephone Number	:	713-244-9992

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	06/19/2008

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