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General NPI Number Information
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NPI Number | 1871724864
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Entity Type | Organization
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Legal Business Name | LONE STAR AMBULANCE 1, LLC
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Dates
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Enumeration Date | 08/07/2009
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 500 N SHORELINE BLVD STE 906
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City | CORPUS CHRISTI
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State | TX
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Zip | 78401-0399
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Country | US
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Telephone | 855-576-7450
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Fax | 512-869-1633
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Provider Business Mailing Address
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Address Line | PO BOX 2775
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City | GEORGETOWN
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State | TX
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Zip | 78627-2775
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Country | US
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Telephone | 254-935-2424
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Fax | 254-935-2457
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Authorized Official
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Title or Position | CEO
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Name | DAVID LEE
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Credential |
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Telephone | 855-576-7450
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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 | 1000327
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License Number State | TX
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