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General NPI Number Information
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NPI Number | 1093098089
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Entity Type | Organization
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Legal Business Name | JENESIS EMERGENCY SERVICES,INC.
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Dates
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Enumeration Date | 09/26/2011
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 3501 CONVENT AVE
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City | LAREDO
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State | TX
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Zip | 78041-4727
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Country | US
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Telephone | 956-712-3326
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Fax | 956-712-3376
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Provider Business Mailing Address
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Address Line | 3501 CONVENT AVE
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City | LAREDO
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State | TX
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Zip | 78041-4727
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Country | US
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Telephone | 956-712-3326
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Fax | 956-712-3376
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Authorized Official
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Title or Position | CEO
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Name | MS. VERONICA AMPARO MALACARA
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Credential |
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Telephone | 956-324-8758
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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 | 1000699
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License Number State | TX
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