1134279425 NPI number — SAN MARCOS-HAYS COUNTY EMERGENCY MEDICAL SERVICES INCORPORATED

Table of content: (NPI 1134279425)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134279425 NPI number — SAN MARCOS-HAYS COUNTY EMERGENCY MEDICAL SERVICES INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAN MARCOS-HAYS COUNTY EMERGENCY MEDICAL SERVICES INCORPORATED
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:
1134279425
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2061 CLOVIS BARKER RD BLDG 10-B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN MARCOS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78666-1073
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-353-5115
Provider Business Mailing Address Fax Number:
512-353-1491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2061 CLOVIS BARKER
Provider Second Line Business Practice Location Address:
BUILDING 10-B
Provider Business Practice Location Address City Name:
SAN MARCOS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78666-1073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-353-5115
Provider Business Practice Location Address Fax Number:
512-353-1491
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
512-353-5115

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  105004 , 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: 088212801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590010570 . This is a "RR MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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