MEDICARE: CITY OF EL CAMPO

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	241002	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590001000	OTHER		PALMETTO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225010291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF EL CAMPO

Provider Business Mailing Address
First Line	:	PO BOX 4897 DEPT #569
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77210-4897
Country	:	US
Telephone Number	:	855-626-9660
Fax Number	:	833-953-0588

Provider Business Practice Location Address
First Line	:	1011 WEST LOOP
Second Line	:
City	:	EL CAMPO
State	:	TX
Zip	:	77437-9480
Country	:	US
Telephone Number	:	979-543-3335
Fax Number	:	979-541-5062

Authorized Official
Title or Position	:	EMS DIRECTOR
Name	:	MR. GARRET BUBELA
Credential	:
Telephone Number	:	979-543-3335

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	03/22/2022

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Directions to “CITY OF EL CAMPO ” Practice Location

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