Healthcare Provider Details

I. General information

NPI: 1295720324
Provider Name (Legal Business Name): ALL TEXAS AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 HILLCROFT ST 801
HOUSTON TX
77036-2296
US

IV. Provider business mailing address

5645 HILLCROFT ST 801
HOUSTON TX
77036-2296
US

V. Phone/Fax

Practice location:
  • Phone: 713-244-9992
  • Fax: 713-224-9975
Mailing address:
  • Phone: 713-244-9992
  • Fax: 713-224-9975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DERRICK TILLMAN
Title or Position: DIRECTOR
Credential:
Phone: 713-244-9992