MEDICARE: ALLIANCE AMBULANCE, 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	341600000X	Ambulance	101212	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4644548	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1356335806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE AMBULANCE, INC

Provider Business Mailing Address
First Line	:	6214 SAXON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-6247
Country	:	US
Telephone Number	:	713-682-2273
Fax Number	:	713-682-5815

Provider Business Practice Location Address
First Line	:	6214 SAXON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-6247
Country	:	US
Telephone Number	:	713-682-2273
Fax Number	:	713-682-5815

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	JON EDENS
Credential	:
Telephone Number	:	713-682-2273

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	09/24/2013

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Directions to “ALLIANCE AMBULANCE, INC ” Practice Location

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