MEDICARE: MID TOWN 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	800084	TX

General Provider Information

NPI Number	:	1578501938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MID TOWN EMS INC

Provider Business Mailing Address
First Line	:	PO BOX 752092
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77275-2092
Country	:	US
Telephone Number	:	281-914-6566
Fax Number	:

Provider Business Practice Location Address
First Line	:	7999 HANSEN RD
Second Line	:	SUITE 310
City	:	HOUSTON
State	:	TX
Zip	:	77061-3481
Country	:	US
Telephone Number	:	281-914-6566
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EARL WILLIAMS JR.
Credential	:
Telephone Number	:	281-914-6566

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	10/15/2007

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