1699096636 NPI number — PLATINUM EMS INC

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 1699096636 NPI number — PLATINUM EMS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLATINUM EMS INC
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:
1699096636
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12660 STAFFORD RD
Provider Second Line Business Mailing Address:
SUITE 416
Provider Business Mailing Address City Name:
STAFFORD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77477-3560
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-542-0941
Provider Business Mailing Address Fax Number:
713-771-5081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12660 STAFFORD RD
Provider Second Line Business Practice Location Address:
SUITE 416
Provider Business Practice Location Address City Name:
STAFFORD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77477-3560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-542-0941
Provider Business Practice Location Address Fax Number:
713-771-5081
Provider Enumeration Date:
06/14/2010

Additional Information

Authorized Official

Authorized Official Last Name:
OMEZI
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
832-542-0941

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1000461 , 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: 1000461 . This is a "TEXAS DEPARTMENT OF STATE HEALTH SERVICES" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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