=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053317503
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOWN OF FLOWER MOUND
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2005
-----------------------------------------------------
Last Update Date | 07/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3838 FORUMS DR
-----------------------------------------------------
City | FLOWER MOUND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75028-1815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-874-6270
-----------------------------------------------------
Fax | 972-874-6470
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2121 CROSS TIMBERS RD
-----------------------------------------------------
City | FLOWER MOUND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75028-2602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-874-6022
-----------------------------------------------------
Fax | 972-874-6479
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DEPUTY CHIEF OF EMS
-----------------------------------------------------
Name | ROBERT ADCOCK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 972-768-2518
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 061004
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------