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General NPI Number Information
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NPI Number | 1093865735
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Entity Type | Organization
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Legal Business Name | LAREDO CRITICAL CARE AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 707 E CALTON RD SUITE 203
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City | LAREDO
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State | TX
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Zip | 78041-3638
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Country | US
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Telephone | 956-795-0639
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Fax | 956-795-0364
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Provider Business Mailing Address
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Address Line | 707 E CALTON RD SUITE 203
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City | LAREDO
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State | TX
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Zip | 78041-3638
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Country | US
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Telephone | 956-795-0639
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Fax | 956-795-0364
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Authorized Official
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Title or Position | MANAGER
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Name | HECTOR G SALAS
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Credential |
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Telephone | 956-795-0639
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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 | 3416L0300X
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License Number State | TX
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