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General NPI Number Information
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NPI Number | 1831155647
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Entity Type | Organization
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Legal Business Name | CITY OF BRYAN
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 300 SOUTH TEXAS AVE
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City | BRYAN
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State | TX
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Zip | 77803-3226
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Country | US
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Telephone | 979-209-5080
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Fax | 979-209-5095
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Provider Business Mailing Address
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Address Line | P.O. BOX 1000
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City | BRYAN
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State | TX
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Zip | 77805-1000
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Country | US
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Telephone | 979-209-5080
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Fax | 979-209-5095
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Authorized Official
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Title or Position | EMS CHIEF
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Name | CORY MATTHEWS
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Credential |
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Telephone | 979-209-5970
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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 | 021006
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License Number State | TX
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