1730186636 NPI number — CITY OF KERRVILLE

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 1730186636 NPI number — CITY OF KERRVILLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF KERRVILLE
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:
1730186636
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7900 NW 154TH ST STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI LAKES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33016-5816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-257-8449
Provider Business Mailing Address Fax Number:
830-315-0576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
365 CLEARWATER PASEO STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KERRVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78028-2429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-257-8449
Provider Business Practice Location Address Fax Number:
830-315-0576
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MALONEY
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
830-257-8499

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  133011 , 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: 617580 . This is a "BCBS OF VIRGINIA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 088239101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0194271 . This is a "DEPT OF LABOR & INDUSTRIE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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