1750466033 NPI number — NUECES COUNTY RURAL FIRE DISTRICT NO 4

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 1750466033 NPI number — NUECES COUNTY RURAL FIRE DISTRICT NO 4

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NUECES COUNTY RURAL FIRE DISTRICT NO 4
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:
1750466033
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 260176
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78426-0176
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-387-4066
Provider Business Mailing Address Fax Number:
361-387-7117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5781 FM 666
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROBSTOWN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78380-5246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-387-4066
Provider Business Practice Location Address Fax Number:
361-387-7117
Provider Enumeration Date:
10/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BLUNTZER
Authorized Official First Name:
DIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
361-960-8921

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  300203 , 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: 590012683 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000704901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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