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General NPI Number Information
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NPI Number | 1336357862
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Entity Type | Organization
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Legal Business Name | ANAHUAC EMERGENCY CORPS
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 511 MILLER STREET
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City | ANAHUAC
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State | TX
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Zip | 77514-1410
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Country | US
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Telephone | 409-267-6080
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Fax | 409-267-4247
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Provider Business Mailing Address
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Address Line | 511 MILLER STREET
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City | ANAHUAC
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State | TX
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Zip | 77514-1410
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Country | US
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Telephone | 409-267-6080
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Fax | 409-267-4247
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Authorized Official
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Title or Position | EMTP SUPERVISOR
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Name | DERRICK W WILSON
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Credential |
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Telephone | 409-267-6080
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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 | 036001
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License Number State | TX
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