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General NPI Number Information
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NPI Number | 1629216254
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Entity Type | Organization
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Legal Business Name | PROTEC AMBULANCE TRANSPORT
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 900 GRANBERRY ST
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City | HUMBLE
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State | TX
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Zip | 77338-4757
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Country | US
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Telephone | 281-548-7771
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1708
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City | HUMBLE
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State | TX
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Zip | 77347-1708
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Country | US
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Telephone | 281-330-0330
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL RAY RUSSELL
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Credential |
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Telephone | 281-548-7771
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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 | 800078
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License Number State | TX
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