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General NPI Number Information
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NPI Number | 1124057948
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Entity Type | Organization
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Legal Business Name | CITY OF KEENE TEX
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 203 W HILLCREST
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City | KEENE
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State | TX
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Zip | 76059
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Country | US
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Telephone | 817-648-7536
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Fax | 817-645-8080
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Provider Business Mailing Address
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Address Line | 100 N MOCKINGBIRD LN
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City | KEENE
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State | TX
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Zip | 76059-2323
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Country | US
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Telephone | 817-556-2474
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Fax | 817-645-8080
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHELLE BEESON
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Credential | MD
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Telephone | 972-339-4234
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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 | 300110
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License Number State | TX
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