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General NPI Number Information
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NPI Number | 1548531338
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Entity Type | Organization
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Legal Business Name | STAR AMBULANCE SERVICE LLC
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Dates
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Enumeration Date | 01/25/2012
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 219 B. N BROADWAY
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City | ELSA
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State | TX
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Zip | 78543-0000
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Country | US
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Telephone | 956-720-4782
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1250
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City | ELSA
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State | TX
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Zip | 78543-1250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. SILVIA MARTINEZ
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Credential |
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Telephone | 956-720-4782
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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 | 1000769
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1000769
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License Number State | TX
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