Healthcare Provider Details

I. General information

NPI: 1053644625
Provider Name (Legal Business Name): DILLEY AMBULANCE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W MILLER ST
DILLEY TX
78017-3819
US

IV. Provider business mailing address

211 W MILLER ST
DILLEY TX
78017-3819
US

V. Phone/Fax

Practice location:
  • Phone: 830-965-2034
  • Fax: 830-965-1769
Mailing address:
  • Phone: 830-965-2034
  • Fax: 830-965-1769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MISS JESSICA L VILLANUEVA
Title or Position: OWNER
Credential:
Phone: 830-965-2034