Provider Demographics
NPI:1043526379
Name:AA AMBULANCE SERVICES LLC
Entity Type:Organization
Organization Name:AA AMBULANCE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-865-6626
Mailing Address - Street 1:PO BOX 2740
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77516-2740
Mailing Address - Country:US
Mailing Address - Phone:281-777-7733
Mailing Address - Fax:713-661-2504
Practice Address - Street 1:13087 S HIGHWAY 288B
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-9660
Practice Address - Country:US
Practice Address - Phone:713-661-2500
Practice Address - Fax:713-661-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000498341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB1075Medicare UPIN
TXAMB1075Medicare PIN