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General NPI Number Information
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NPI Number | 1194770255
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Entity Type | Organization
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Legal Business Name | SOUTHEAST TEXAS EMS
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 5055 BRAGG CIRCLE
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City | BEAUMONT
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State | TX
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Zip | 77705
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Country | US
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Telephone | 409-898-4740
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Fax | 409-898-4753
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Provider Business Mailing Address
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Address Line | PO BOX 12898
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City | BEAUMONT
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State | TX
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Zip | 77726
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Country | US
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Telephone | 409-898-4740
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Fax | 409-898-4753
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Authorized Official
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Title or Position | OFFICE & BILLING MANAGER
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Name | MRS. CYNTHIA ANN BRIDGES
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Credential |
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Telephone | 409-898-4740
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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 | 123026
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License Number State | TX
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