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NPI Code Detail

MEDICARE: MAGNOLIA EMS, LLC

MEDICARE: MAGNOLIA EMS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1341600000XAmbulance1000570TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124326095
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAGNOLIA EMS, LLC
Provider Business Mailing Address
First Line : 6550 MAPLERIDGE ST STE 119
Second Line :
City : HOUSTON
State : TX
Zip : 77081-4629
Country : US
Telephone Number : 713-660-0558
Fax Number : 713-660-0935
Provider Business Practice Location Address
First Line : 6550 MAPLERIDGE ST STE 119
Second Line :
City : HOUSTON
State : TX
Zip : 77081-4629
Country : US
Telephone Number : 713-660-0558
Fax Number : 713-660-0935
Authorized Official
Title or Position : CEO
Name : MR. MICHAEL J CAVAZOS
Credential :
Telephone Number : 713-660-0558
Provider Enumeration Date : 03/02/2011
Last Update Date : 03/24/2022

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Directions to “MAGNOLIA EMS, LLC ” Practice Location

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