Healthcare Provider Details

I. General information

NPI: 1780652248
Provider Name (Legal Business Name): CHANNELVIEW EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16010 RIDLON
CHANNELVIEW TX
77530
US

IV. Provider business mailing address

PO BOX 691363
HOUSTON TX
77269-1363
US

V. Phone/Fax

Practice location:
  • Phone: 281-452-5782
  • Fax: 281-452-2100
Mailing address:
  • Phone: 281-397-0397
  • Fax: 281-397-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateTX

VIII. Authorized Official

Name: KAREN LAAKE
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 281-397-0397