=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043239296
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTLAKE VOLUNTEER FIRE DEPARTMENT, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2006
-----------------------------------------------------
Last Update Date | 04/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19636 SAUMS RD
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77084-4732
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-492-0560
-----------------------------------------------------
Fax | 281-492-0561
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19703 SAUMS RD
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77084-4733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-492-0560
-----------------------------------------------------
Fax | 281-492-0561
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FIRE CHIEF/DIRECTOR
-----------------------------------------------------
Name | MARC PALMER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 832-347-3710
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 101008
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------