MEDICARE: EAGLE EMS 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	:	1881630267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE EMS LLC

Provider Business Mailing Address
First Line	:	1505 HUSSION ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-4803
Country	:	US
Telephone Number	:	713-227-1045
Fax Number	:	713-227-1072

Provider Business Practice Location Address
First Line	:	1505 HUSSION ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-4803
Country	:	US
Telephone Number	:	713-227-1045
Fax Number	:	713-227-1072

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. JESUS GREGORIO CONTRERAS
Credential	:	EMT BASIC
Telephone Number	:	281-881-1287

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	04/30/2010

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Directions to “EAGLE EMS LLC ” Practice Location

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