Healthcare Provider Details

I. General information

NPI: 1548241813
Provider Name (Legal Business Name): CITY OF MINERAL WELLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 SW 1ST AVE
MINERAL WELLS TX
76067-5267
US

IV. Provider business mailing address

211 SW 1ST AVE
MINERAL WELLS TX
76067-5267
US

V. Phone/Fax

Practice location:
  • Phone: 940-328-7730
  • Fax: 940-328-7731
Mailing address:
  • Phone: 940-328-7730
  • Fax: 940-328-7731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number182001
License Number StateTX

VIII. Authorized Official

Name: RYAN DUNN
Title or Position: FIRE CHIEF
Credential:
Phone: 940-328-7730