MEDICARE: CANYON LAKE FIRE/EMS

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	046001	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

General Provider Information

NPI Number	:	1932199148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANYON LAKE FIRE/EMS

Provider Business Mailing Address
First Line	:	PO BOX 2140
Second Line	:
City	:	CANYON LAKE
State	:	TX
Zip	:	78133-0024
Country	:	US
Telephone Number	:	830-907-2922
Fax Number	:	830-907-2408

Provider Business Practice Location Address
First Line	:	1425 SATTLER RD
Second Line	:
City	:	CANYON LAKE
State	:	TX
Zip	:	78132-2213
Country	:	US
Telephone Number	:	830-907-2922
Fax Number	:	830-907-2408

Authorized Official
Title or Position	:	CHIEF
Name	:	MR. SHAWN MICHAEL WHERRY
Credential	:	FF/EMT-P
Telephone Number	:	830-907-2922

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	04/10/2009

Similar Medicare Providers

1861490294 — DR. YVONNE CATHERINE HUCKLEBERRY PHARMD
Practice Location Address:

3577 E NUGGET CANYON PL
TUCSON, AZ
85718-2213

Practice Phone: 520-615-2644
Practice Fax:

1801859129 — DAVID MORGAN PETERSON PA-C
Practice Location Address:

1395 SATTLER RD , SUITE 6
CANYON LAKE, TX
78132-2295

Practice Phone: 830-904-4311
Practice Fax: 830-885-5541

1033287107 — JOSE ANGEL MARTINEZ JR. PA-C
Practice Location Address:

1395 SATTLER RD STE 6
CANYON LAKE, TX
78132-2296

Practice Phone: 830-964-5575
Practice Fax: 830-964-2294

1811049570 — DR. FRED H WILSON III DDS
Practice Location Address:

1395 SATTLER RD STE 4
CANYON LAKE, TX
78132-2296

Practice Phone: 830-964-3161
Practice Fax: 830-226-5019

1013565639 — DR. JOSEPHINE A THAN PHARMD
Practice Location Address:

1395 SATTLER RD STE 8
CANYON LAKE, TX
78132-2296

Practice Phone: 830-964-3615
Practice Fax:

1689284960 — DR. JAMES RAYMOND NOTTE
Practice Location Address:

1395 SATTLER RD STE 8
CANYON LAKE, TX
78132-2296

Practice Phone: 830-964-3615
Practice Fax:

Directions to “CANYON LAKE FIRE/EMS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.