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General NPI Number Information
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NPI Number | 1073823985
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Entity Type | Organization
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Legal Business Name | GENESIS AMBULANCE INC
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 7343 ATHLONE DR
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City | HOUSTON
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State | TX
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Zip | 77088-7422
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Country | US
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Telephone | 281-714-7220
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Fax | 281-931-5073
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Provider Business Mailing Address
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Address Line | 7343 ATHLONE DR
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City | HOUSTON
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State | TX
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Zip | 77088-7422
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Country | US
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Telephone | 281-714-7220
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Fax | 281-931-5073
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARY ELLA RICHARDSON
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Credential |
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Telephone | 281-714-7220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1000475
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License Number State | TX
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