Healthcare Provider Details

I. General information

NPI: 1346313327
Provider Name (Legal Business Name): LOS FRESNOS AMBULANCE SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N BRAZIL ST
LOS FRESNOS TX
78566-3640
US

IV. Provider business mailing address

PO BOX 776
LOS FRESNOS TX
78566-0776
US

V. Phone/Fax

Practice location:
  • Phone: 956-233-5007
  • Fax: 956-233-8608
Mailing address:
  • Phone: 956-233-5007
  • Fax: 956-233-8608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number031014
License Number StateTX

VIII. Authorized Official

Name: MR. GENE DANIELS
Title or Position: DIRECTOR
Credential: EMT-P
Phone: 956-233-5007