Healthcare Provider Details
I. General information
NPI: 1669610879
Provider Name (Legal Business Name): ZODIAC EMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2009
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9888 BISSONNET ST STE 655
HOUSTON TX
77036-8247
US
IV. Provider business mailing address
9888 BISSONNET ST STE 655
HOUSTON TX
77036-8247
US
V. Phone/Fax
- Phone: 713-771-1741
- Fax: 713-771-1773
- Phone: 713-771-1741
- Fax: 713-771-1773
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | 1000219 |
| License Number State | TX |
VIII. Authorized Official
Name: MRS.
ANULI
J
NDUBUISI
Title or Position: CEO
Credential:
Phone: 713-771-1741