MEDICARE: WALKER COUNTY

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	236004	TX
2	341600000X	Ambulance	236004	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	236004	OTHER	TX	TEXAS PROVIDER LICENSE

General Provider Information

NPI Number	:	1710977061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALKER COUNTY

Provider Business Mailing Address
First Line	:	PO BOX 1602
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77342-1602
Country	:	US
Telephone Number	:	936-295-4848
Fax Number	:	936-435-2482

Provider Business Practice Location Address
First Line	:	1619 HIGHWAY 30 E
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77320-5491
Country	:	US
Telephone Number	:	936-295-4848
Fax Number	:	936-435-2482

Authorized Official
Title or Position	:	EMS DIRECTOR
Name	:	RACHEL PARKER
Credential	:
Telephone Number	:	936-295-4848

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	08/04/2023

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1861418147 — TRI-COUNTY BEHAVIORAL HEALTHCARE
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Directions to “WALKER COUNTY ” Practice Location

Language	Start Address	Practice Location

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