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General NPI Number Information
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NPI Number | 1063550168
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Entity Type | Organization
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Legal Business Name | CITY OF DESOTO
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 211 E PLEASANT RUN RD
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City | DESOTO
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State | TX
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Zip | 75115-3901
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Country | US
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Telephone | 972-230-9628
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Fax | 972-230-5795
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Provider Business Mailing Address
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Address Line | 211 E PLEASANT RUN RD
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City | DESOTO
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State | TX
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Zip | 75115-3901
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Country | US
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Telephone | 972-230-9628
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Fax | 972-230-5795
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Authorized Official
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Title or Position | EMS CHIEF
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Name | BRYAN WHITACRE
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Credential |
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Telephone | 972-230-9682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 057044
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License Number State | TX
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