Healthcare Provider Details

I. General information

NPI: 1134263486
Provider Name (Legal Business Name): CITY OF DUBLIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 E BLACKJACK ST
DUBLIN TX
76446-2303
US

IV. Provider business mailing address

213 E BLACKJACK ST
DUBLIN TX
76446-2303
US

V. Phone/Fax

Practice location:
  • Phone: 254-445-3727
  • Fax:
Mailing address:
  • Phone: 254-445-3727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number072001
License Number StateTX

VIII. Authorized Official

Name: JOHN TADLOCK
Title or Position: EMS DIRECTOR
Credential:
Phone: 254-485-6095