MEDICARE: TEXAS REGIONAL 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	341600000X	Ambulance		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AMB 655	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1588617740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS REGIONAL EMS INC.

Provider Business Mailing Address
First Line	:	1538 CR 345
Second Line	:
City	:	KARNES CITY
State	:	TX
Zip	:	78118
Country	:	US
Telephone Number	:	830-569-5755
Fax Number	:	830-583-3179

Provider Business Practice Location Address
First Line	:	1538 COUNTY ROAD 345
Second Line	:
City	:	KARNES CITY
State	:	TX
Zip	:	78118-5618
Country	:	US
Telephone Number	:	830-569-5755
Fax Number	:	830-583-3179

Authorized Official
Title or Position	:	PRESIDENT/OFFICE MANAGER
Name	:	MRS. STACIE RAE KELLEY
Credential	:
Telephone Number	:	830-569-5755

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	04/20/2008

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Directions to “TEXAS REGIONAL EMS INC. ” Practice Location

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