1417467812 NPI number — HARRIS COUNTY EMERGENCY SERVICES NO4

Table of content: MR. DAVID CARROLL SWAIN LGPC (NPI 1033707260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417467812 NPI number — HARRIS COUNTY EMERGENCY SERVICES NO4

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRIS COUNTY EMERGENCY SERVICES NO4
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417467812
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1028
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUFFMAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77336-1028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-913-6100
Provider Business Mailing Address Fax Number:
281-324-3881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
54 IVY LEAF DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUFFMAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77336-3301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-913-6100
Provider Business Practice Location Address Fax Number:
281-324-3881
Provider Enumeration Date:
10/11/2017

Additional Information

Authorized Official

Authorized Official Last Name:
NANCE
Authorized Official First Name:
CODY
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT CHIEF-EMS
Authorized Official Telephone Number:
409-289-5613

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1000971 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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