MEDICARE: BEEVILLE ANGEL CARE AMBULANCE SERVICE, 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	013003	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590014484	OTHER	TX	MEDICARE RAILROAD

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
3	AMB572	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1699772004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEEVILLE ANGEL CARE AMBULANCE SERVICE, INC

Provider Business Mailing Address
First Line	:	1105 W CORPUS CHRISTI ST
Second Line	:	P. O. BOX 1293
City	:	BEEVILLE
State	:	TX
Zip	:	78102-5513
Country	:	US
Telephone Number	:	361-358-6472
Fax Number	:	361-358-6743

Provider Business Practice Location Address
First Line	:	1105 W CORPUS CHRISTI ST
Second Line	:
City	:	BEEVILLE
State	:	TX
Zip	:	78102-5513
Country	:	US
Telephone Number	:	361-358-6472
Fax Number	:	361-358-6473

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GABRIEL ALEMAN
Credential	:
Telephone Number	:	361-358-6472

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	10/01/2013

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Directions to “BEEVILLE ANGEL CARE AMBULANCE SERVICE, INC ” Practice Location

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