Healthcare Provider Details

I. General information

NPI: 1013025089
Provider Name (Legal Business Name): FRANK AND BRENDA JENNINGS DBA COTULLA EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 01/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 N CHEROKEE AVE
COTULLA TX
78014-2026
US

IV. Provider business mailing address

PO BOX 65
COTULLA TX
78014-0065
US

V. Phone/Fax

Practice location:
  • Phone: 830-879-3331
  • Fax:
Mailing address:
  • Phone: 830-879-3331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number142004
License Number StateTX

VIII. Authorized Official

Name: MRS. KAY A WEST
Title or Position: MANAGER
Credential:
Phone: 210-822-4059