MEDICARE: ST CHRISTINAS EMS

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	1000287	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1000287	OTHER	TX	STATE LICENSE

General Provider Information

NPI Number	:	1730310657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST CHRISTINAS EMS

Provider Business Mailing Address
First Line	:	6702 HARPERS DR
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-5909
Country	:	US
Telephone Number	:	979-559-2961
Fax Number	:

Provider Business Practice Location Address
First Line	:	6702 HARPERS DR
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-5909
Country	:	US
Telephone Number	:	979-559-2961
Fax Number	:

Authorized Official
Title or Position	:	BILLING AGENT
Name	:	AUTUMN MARIE LOPEZ
Credential	:
Telephone Number	:	281-777-9406

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	07/28/2009

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Directions to “ST CHRISTINAS EMS ” Practice Location

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