Healthcare Provider Details

I. General information

NPI: 1750396610
Provider Name (Legal Business Name): TOWN OF WESTLAKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 DOVE RD
WESTLAKE TX
76262
US

IV. Provider business mailing address

1500 SOLANA BLVD STE 7200
WESTLAKE TX
76262-1690
US

V. Phone/Fax

Practice location:
  • Phone: 817-490-5785
  • Fax:
Mailing address:
  • Phone: 817-490-5713
  • Fax: 817-430-1812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number300470
License Number StateTX

VIII. Authorized Official

Name: RICHARD CHAPMAN WHITTEN
Title or Position: FIRE CHIEF
Credential:
Phone: 817-490-5780