Provider Demographics
NPI:1023012432
Name:CITY OF TEXLINE
Entity Type:Organization
Organization Name:CITY OF TEXLINE
Other - Org Name:TEXLINE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF CREDENTIALING SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:COULTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-336-8321
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:TEXLINE
Mailing Address - State:TX
Mailing Address - Zip Code:79087-0144
Mailing Address - Country:US
Mailing Address - Phone:806-336-8321
Mailing Address - Fax:806-362-4226
Practice Address - Street 1:519 S 2ND ST
Practice Address - Street 2:
Practice Address - City:TEXLINE
Practice Address - State:TX
Practice Address - Zip Code:79087
Practice Address - Country:US
Practice Address - Phone:806-333-4809
Practice Address - Fax:806-362-4226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0560023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165164801Medicaid
TX165164801Medicaid
TX165164801Medicaid
TXAMB287Medicare PIN