MEDICARE: CITY OF PORT ARANSAS

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
1	341600000X	Ambulance	178020	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	178020	OTHER	TX	DSHS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184643850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF PORT ARANSAS

Provider Business Mailing Address
First Line	:	705 W AVENUE A
Second Line	:
City	:	PORT ARANSAS
State	:	TX
Zip	:	78373-4112
Country	:	US
Telephone Number	:	361-749-4405
Fax Number	:	361-749-4490

Provider Business Practice Location Address
First Line	:	628 W AVENUE A
Second Line	:
City	:	PORT ARANSAS
State	:	TX
Zip	:	78373-4100
Country	:	US
Telephone Number	:	361-749-4405
Fax Number	:	361-749-4490

Authorized Official
Title or Position	:	EMS CHIEF
Name	:	DANIEL L JOHNSON
Credential	:
Telephone Number	:	361-438-4413

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	09/26/2024

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Directions to “CITY OF PORT ARANSAS ” Practice Location

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