Healthcare Provider Details

I. General information

NPI: 1154452431
Provider Name (Legal Business Name): CITY OF WILLS POINT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N 5TH STREET
WILLS POINT TX
75169
US

IV. Provider business mailing address

PO BOX 700847
DALLAS TX
75370-0847
US

V. Phone/Fax

Practice location:
  • Phone: 903-873-2578
  • Fax: 903-873-5512
Mailing address:
  • Phone: 972-250-2023
  • Fax: 972-250-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number234018
License Number StateTX

VIII. Authorized Official

Name: CARLA T OLDACE
Title or Position: CITY SECRETARY
Credential:
Phone: 903-873-2578