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General NPI Number Information
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NPI Number | 1316916497
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Entity Type | Organization
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Legal Business Name | GEORGETOWN AMBULANCE SE
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2000 SCENIC DRIVE
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City | GEORGETOWN
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State | TX
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Zip | 78626
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Country | US
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Telephone | 512-942-4262
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Fax | 512-942-4138
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Provider Business Mailing Address
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Address Line | PO BOX 691363
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City | HOUSTON
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State | TX
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Zip | 77269-1363
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Country | US
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Telephone | 281-397-0397
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Fax | 281-397-0007
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | KAREN LAAKE
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Credential |
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Telephone | 281-397-0397
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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 |
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License Number State | TX
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