=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831207919
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVANCED CARDIAC AND TRAUMA EMERGENCY MEDICAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2006
-----------------------------------------------------
Last Update Date | 08/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1601 E MILE 14 1/2 N
-----------------------------------------------------
City | WESLACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78596-2466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-262-1163
-----------------------------------------------------
Fax | 956-262-3020
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1601 E MILE 14 1/2 N
-----------------------------------------------------
City | WESLACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78596-2466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-262-1163
-----------------------------------------------------
Fax | 956-262-3020
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. RICARDO F VAIZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-262-1163
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 108048
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------