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General NPI Number Information
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NPI Number | 1184961823
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Entity Type | Organization
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Legal Business Name | DILLEY AMBULANCE SERVICE, INC
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 1118 COMMERCE DR
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City | LAREDO
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State | TX
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Zip | 78042
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Country | US
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Telephone | 956-220-0821
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Fax | 956-269-1088
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Provider Business Mailing Address
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Address Line | 217 W MILLER ST
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City | DILLEY
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State | TX
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Zip | 78017-3819
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Country | US
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Telephone | 830-965-6891
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Fax | 830-965-6891
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Authorized Official
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Title or Position | OWNER
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Name | MS. JESSICA L VILLANUEVA
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Credential |
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Telephone | 830-965-6891
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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 | 1000513
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License Number State | TX
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