MEDICARE: LONE STAR SPEED EMS, INC.

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	3416L0300X	Land Ambulance	1000029	TX
2	341600000X	Ambulance	1000029	TX

General Provider Information

NPI Number	:	1235321498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONE STAR SPEED EMS, INC.

Provider Business Mailing Address
First Line	:	525 N SAM HOUSTON PKWY E
Second Line	:	#360-I
City	:	HOUSTON
State	:	TX
Zip	:	77060-4037
Country	:	US
Telephone Number	:	832-868-5122
Fax Number	:	713-952-6279

Provider Business Practice Location Address
First Line	:	525 N SAM HOUSTON PKWY E
Second Line	:	#360-I
City	:	HOUSTON
State	:	TX
Zip	:	77060-4037
Country	:	US
Telephone Number	:	832-868-5122
Fax Number	:	713-952-6279

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. FEFI JAMES
Credential	:
Telephone Number	:	832-868-5122

Provider Enumeration Date	:	08/13/2007
Last Update Date	:	10/28/2008

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Directions to “LONE STAR SPEED EMS, INC. ” Practice Location

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