MEDICARE: MEDI-CAB EXPRESS OF TEXAS, LP

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		TX

General Provider Information

NPI Number	:	1932492501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDI-CAB EXPRESS OF TEXAS, LP

Provider Business Mailing Address
First Line	:	2461 EL INDIO HWY
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-5538
Country	:	US
Telephone Number	:	830-352-2140
Fax Number	:	830-773-8772

Provider Business Practice Location Address
First Line	:	2461 EL INDIO HWY
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-5538
Country	:	US
Telephone Number	:	830-352-2140
Fax Number	:	830-773-8772

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	JAMES CLARY
Credential	:
Telephone Number	:	830-773-0900

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	05/16/2011

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