Provider Demographics
NPI:1033458385
Name:DPAR ROADRUNNER LLC, DBA ALLEGIANCE AMBULANCE
Entity Type:Organization
Organization Name:DPAR ROADRUNNER LLC, DBA ALLEGIANCE AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-576-7450
Mailing Address - Street 1:PO BOX 2775
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78627-2775
Mailing Address - Country:US
Mailing Address - Phone:855-576-7450
Mailing Address - Fax:
Practice Address - Street 1:501 S AUSTIN AVE
Practice Address - Street 2:SUITE 1310
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-5637
Practice Address - Country:US
Practice Address - Phone:855-576-7450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10008693416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport