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General NPI Number Information
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NPI Number | 1073726667
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Entity Type | Organization
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Legal Business Name | CHANNELVIEW VOLUNTEER FIRE D
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 16010 RIDLON ST
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City | CHANNELVIEW
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State | TX
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Zip | 77530-3614
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Country | US
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Telephone | 281-452-5782
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Fax | 281-452-2100
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Provider Business Mailing Address
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Address Line | PO BOX 691363
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City | HOUSTON
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State | TX
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Zip | 77269-1363
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Country | US
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Telephone | 281-397-0397
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Fax | 281-397-6934
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | KAREN P LAAKE
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Credential |
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Telephone | 281-397-0397
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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 | 101014
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License Number State | TX
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