Provider Demographics
NPI:1033240718
Name:CITY OF CARROLLTON
Entity Type:Organization
Organization Name:CITY OF CARROLLTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-466-3393
Mailing Address - Street 1:PO BOX 115125
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-5125
Mailing Address - Country:US
Mailing Address - Phone:972-466-4746
Mailing Address - Fax:972-389-9523
Practice Address - Street 1:1945 E JACKSON RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1737
Practice Address - Country:US
Practice Address - Phone:972-466-4746
Practice Address - Fax:972-389-9523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX057012146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0863458-01Medicaid
TX0863458-01Medicaid
TX0863458-01Medicaid