Healthcare Provider Details

I. General information

NPI: 1114242344
Provider Name (Legal Business Name): COMMIT CARE EMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4625 FM 2920 RD
SPRING TX
77388-3106
US

IV. Provider business mailing address

4625 FM 2920 RD
SPRING TX
77388-3106
US

V. Phone/Fax

Practice location:
  • Phone: 281-745-2426
  • Fax:
Mailing address:
  • Phone: 281-745-2426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1000390
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1000390
License Number StateTX

VIII. Authorized Official

Name: MRS. AVERIL BROUSSARD
Title or Position: INSURANCE BILLER
Credential:
Phone: 832-704-4050