MEDICARE: GALVESTON COUNTY EMERGENCY SERVICES DISTRICT -2

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	341600000X	Ambulance
2	3416L0300X	Land Ambulance
3	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician

General Provider Information

NPI Number	:	1245795590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALVESTON COUNTY EMERGENCY SERVICES DISTRICT -2

Provider Business Mailing Address
First Line	:	PO BOX 1575
Second Line	:
City	:	CRYSTAL BEACH
State	:	TX
Zip	:	77650-1575
Country	:	US
Telephone Number	:	409-684-2016
Fax Number	:

Provider Business Practice Location Address
First Line	:	930 NOBLE CARL DRIVE
Second Line	:
City	:	CRYSTAL BEACH
State	:	TX
Zip	:	77650
Country	:	US
Telephone Number	:	409-684-2016
Fax Number	:

Authorized Official
Title or Position	:	DISTRICT MANAGER
Name	:	MR. JAMES DOUGLAS SAUNDERS
Credential	:	EMT
Telephone Number	:	409-684-2016

Provider Enumeration Date	:	01/31/2019
Last Update Date	:	06/04/2019

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