Provider Demographics
NPI:1043239296
Name:WESTLAKE VOLUNTEER FIRE DEPARTMENT, INC
Entity Type:Organization
Organization Name:WESTLAKE VOLUNTEER FIRE DEPARTMENT, INC
Other - Org Name:WESTLAKE VOLUNTEER FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-492-0560
Mailing Address - Street 1:19703 SAUMS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-4733
Mailing Address - Country:US
Mailing Address - Phone:281-492-0560
Mailing Address - Fax:281-492-0561
Practice Address - Street 1:19636 SAUMS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-4732
Practice Address - Country:US
Practice Address - Phone:281-492-0560
Practice Address - Fax:281-492-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101008341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000539901Medicaid
590009776OtherRAILROAD MEDICARE
TX517787OtherBC/BS OF TEXAS