Healthcare Provider Details

I. General information

NPI: 1992863815
Provider Name (Legal Business Name): CITY OF TEXICO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 02/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N. TURNER
TEXICO NM
88135-0208
US

IV. Provider business mailing address

PO BOX 208
TEXICO NM
88135-0208
US

V. Phone/Fax

Practice location:
  • Phone: 505-482-3314
  • Fax: 505-482-9044
Mailing address:
  • Phone: 505-482-3314
  • Fax: 505-482-9044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number52570
License Number StateNM

VIII. Authorized Official

Name: MR. LEWIS L COOPER
Title or Position: FIRE CHIEF
Credential:
Phone: 505-482-3314