Healthcare Provider Details

I. General information

NPI: 1417913955
Provider Name (Legal Business Name): AMBULANCE SERVICE OF LAREDO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6502 N BARTLETT AVE
LAREDO TX
78041-6444
US

IV. Provider business mailing address

6502 N BARTLETT AVE
LAREDO TX
78041-6444
US

V. Phone/Fax

Practice location:
  • Phone: 956-726-1329
  • Fax:
Mailing address:
  • Phone: 956-726-1329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number240014
License Number StateTX

VIII. Authorized Official

Name: VALERIANO ARRIAGA
Title or Position: PRESIDENT
Credential:
Phone: 956-726-1337