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General NPI Number Information
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NPI Number | 1720162423
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Entity Type | Organization
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Legal Business Name | ST. MICHAEL'S AMBULANCE, LLC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 2524 W FREDDY GONZALEZ DR
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City | EDINBURG
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State | TX
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Zip | 78539-7339
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Country | US
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Telephone | 956-601-1269
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Fax | 956-253-1596
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Provider Business Mailing Address
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Address Line | 2524 W FREDDY GONZALEZ DR
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City | EDINBURG
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State | TX
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Zip | 78539-7339
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Country | US
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Telephone | 956-601-1269
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Fax | 956-253-1596
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | HEIDI V SEGOVIA
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Credential |
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Telephone | 956-601-1269
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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 | 800194
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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 |
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License Number State | TX
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