Provider Demographics
NPI:1053505347
Name:NUECES COUNTY EMERGENCY SERVICES DISTRICT NO 1
Entity Type:Organization
Organization Name:NUECES COUNTY EMERGENCY SERVICES DISTRICT NO 1
Other - Org Name:ANNAVILLE FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-241-1372
Mailing Address - Street 1:PO BOX 495548
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75049-5548
Mailing Address - Country:US
Mailing Address - Phone:214-340-2650
Mailing Address - Fax:214-503-7135
Practice Address - Street 1:11551 LEOPARD ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-3415
Practice Address - Country:US
Practice Address - Phone:361-241-1372
Practice Address - Fax:361-242-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10000613416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB675Medicare PIN