1053377713 NPI number — CITY OF SAN ANTONIO TEXAS

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 1053377713 NPI number — CITY OF SAN ANTONIO TEXAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF SAN ANTONIO TEXAS
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:
CITY OF SAN ANTONIO EMERGENCY MEDICAL SERVICE (EMS)
Provider Other Organization Name Type Code:
3
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:
1053377713
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 158
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78291-0158
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-227-7252
Provider Business Mailing Address Fax Number:
210-224-6945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
315 S SANTA ROSA AVE
Provider Second Line Business Practice Location Address:
SUITE 2000
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78207-4557
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-207-7525
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GARZA
Authorized Official First Name:
REYNALDO
Authorized Official Middle Name:
Authorized Official Title or Position:
DIVISION CHIEF OF EMS
Authorized Official Telephone Number:
210-207-7525

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  015009 , 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)

  • Identifier: 107688701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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