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General NPI Number Information
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NPI Number | 1215930672
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Entity Type | Organization
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Legal Business Name | CITY OF BENBROOK
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 528 MERCEDES ST
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City | BENBROOK
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State | TX
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Zip | 76126-2521
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Country | US
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Telephone | 817-249-1727
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Fax | 817-249-0884
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Provider Business Mailing Address
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Address Line | PO BOX 26569
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City | BENBROOK
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State | TX
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Zip | 76126-0569
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Country | US
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Telephone | 817-249-3000
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Fax | 817-249-0884
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MR. TOMMY DAVIS
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Credential |
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Telephone | 817-249-1727
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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 | 220022
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License Number State | TX
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