1467644559 NPI number — ALLIANCE EMERGENCY MEDICAL SERVICES PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467644559 NPI number — ALLIANCE EMERGENCY MEDICAL SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLIANCE EMERGENCY MEDICAL SERVICES PLLC
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:
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:
1467644559
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
808 S SHARY RD
Provider Second Line Business Mailing Address:
STE 5 PMB# 186
Provider Business Mailing Address City Name:
MISSION
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78572-8568
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-583-7447
Provider Business Mailing Address Fax Number:
956-583-7455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1814 VICTORIA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MISSION
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78572-6403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-683-7444
Provider Business Practice Location Address Fax Number:
956-683-7449
Provider Enumeration Date:
08/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CORDERO
Authorized Official First Name:
GUADALUPE
Authorized Official Middle Name:
DEJESUS
Authorized Official Title or Position:
ASSITANT DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
956-240-2315

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1000348 , 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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