Healthcare Provider Details

I. General information

NPI: 1043298953
Provider Name (Legal Business Name): MCMULLEN COUNTY EMERGENCY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 01/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 MESQUITE ST.
TILDEN TX
78072-0444
US

IV. Provider business mailing address

PO BOX 444
TILDEN TX
78072-0444
US

V. Phone/Fax

Practice location:
  • Phone: 361-274-3213
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number156001
License Number StateTX

VIII. Authorized Official

Name: TINA LEE SERRATA
Title or Position: OFFICE MANAGER
Credential:
Phone: 361-274-3213