Healthcare Provider Details

I. General information

NPI: 1376567040
Provider Name (Legal Business Name): CITY OF PILOT POINT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 WEST DIVISION ST.
PILOT POINT TX
76258
US

IV. Provider business mailing address

PO BOX 457
PILOT POINT TX
76258-0457
US

V. Phone/Fax

Practice location:
  • Phone: 940-686-5038
  • Fax: 940-686-2222
Mailing address:
  • Phone: 940-686-5038
  • Fax: 940-686-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number61018
License Number StateTX

VIII. Authorized Official

Name: JONATHAN TSAKONAS
Title or Position: EMS ADMINISTRATOR
Credential:
Phone: 940-686-5038