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General NPI Number Information
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NPI Number | 1790327765
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Entity Type | Organization
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Legal Business Name | GONZALES COUNTY EMERGENCY SERVICES DISTRICT 1
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 305 QUALLS STREET
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City | GONZALES
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State | TX
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Zip | 78629
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Country | US
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Telephone | 830-203-0070
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 743
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City | GONZALES
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State | TX
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Zip | 78629-0743
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Country | US
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Telephone | 830-203-0070
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | EDDIE B CALLENDER
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Credential |
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Telephone | 830-203-0070
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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 |
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License Number State |
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