MEDICARE: MEDIXX AND ASSOCIATES TEXAS, 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

General Provider Information

NPI Number	:	1487088597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDIXX AND ASSOCIATES TEXAS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1983
Second Line	:
City	:	VIDALIA
State	:	GA
Zip	:	30475-1983
Country	:	US
Telephone Number	:	912-538-8505
Fax Number	:	912-538-8545

Provider Business Practice Location Address
First Line	:	1201 N INDUSTRIAL BLVD
Second Line	:	SUITE 200
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2924
Country	:	US
Telephone Number	:	512-388-7100
Fax Number	:	512-388-7103

Authorized Official
Title or Position	:	CEO
Name	:	JOHN V WELCH
Credential	:
Telephone Number	:	912-538-8505

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	11/14/2013

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