=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508478603
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMBULANCE USA, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2020
-----------------------------------------------------
Last Update Date | 04/27/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25807 WESTHEIMER PKWY STE 411
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77494-5333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-872-2222
-----------------------------------------------------
Fax | 832-872-2300
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25807 WESTHEIMER PKWY STE 411
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77494-5369
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-872-2222
-----------------------------------------------------
Fax | 832-872-2300
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | XAVIER PAZ
-----------------------------------------------------
Credential | PARAMEDIC
-----------------------------------------------------
Telephone | 832-872-2222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416A0800X
-----------------------------------------------------
Taxonomy Name | Air Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 347E00000X
-----------------------------------------------------
Taxonomy Name | Transportation Broker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------