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General NPI Number Information
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NPI Number | 1063745685
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Entity Type | Organization
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Legal Business Name | VICS TEXAS TRANSPORT INC
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 4305 N 10TH ST STE J2
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City | MCALLEN
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State | TX
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Zip | 78504-2976
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Country | US
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Telephone | 956-867-4284
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Fax | 956-205-2011
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Provider Business Mailing Address
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Address Line | 4305 N 10TH ST STE J2
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City | MCALLEN
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State | TX
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Zip | 78504-2976
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Country | US
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Telephone | 956-867-4284
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Fax | 956-205-2011
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. VICTOR LEE GONZALEZ I
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Credential |
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Telephone | 956-867-4284
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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 | 1000316
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License Number State | TX
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