Provider Demographics
NPI:1053317503
Name:TOWN OF FLOWER MOUND
Entity Type:Organization
Organization Name:TOWN OF FLOWER MOUND
Other - Org Name:FLOWER MOUND FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:METZGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-874-6201
Mailing Address - Street 1:2121 CROSS TIMBERS RD
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2602
Mailing Address - Country:US
Mailing Address - Phone:972-874-6022
Mailing Address - Fax:972-874-6479
Practice Address - Street 1:3838 FORUMS DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1815
Practice Address - Country:US
Practice Address - Phone:972-874-6270
Practice Address - Fax:972-874-6470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0610043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0003659-01Medicaid
TX514209Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER