MEDICARE: WHITES USA 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	800195	TX

General Provider Information

NPI Number	:	1902986516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITES USA AMBULANCE SERVICE INC

Provider Business Mailing Address
First Line	:	8015 OXFORDSHIRE DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-4671
Country	:	US
Telephone Number	:	832-646-4780
Fax Number	:	888-902-5021

Provider Business Practice Location Address
First Line	:	5504 BANDERA RD
Second Line	:	SUITE 607
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1943
Country	:	US
Telephone Number	:	210-521-2119
Fax Number	:	210-521-2191

Authorized Official
Title or Position	:	OWNER
Name	:	JORESIA MARTEL
Credential	:
Telephone Number	:	832-646-4780

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	02/10/2016

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