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General NPI Number Information
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NPI Number | 1598353708
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Entity Type | Organization
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Legal Business Name | PHOENIX MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 810 W EXPRESSWAY 83
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City | MERCEDES
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State | TX
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Zip | 78570-2240
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Country | US
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Telephone | 956-227-0720
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Fax | 956-338-5750
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Provider Business Mailing Address
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Address Line | PO BOX 659
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City | LA FERIA
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State | TX
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Zip | 78559-0659
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Country | US
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Telephone | 956-227-0720
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Fax | 956-338-5750
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Authorized Official
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Title or Position | OWNER
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Name | DESIDERIO MARTINEZ
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Credential |
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Telephone | 956-684-6690
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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 |
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