Provider Demographics
NPI:1083058739
Name:ACADIAN AMBULANCE SERVICE OF TEXAS LLC
Entity Type:Organization
Organization Name:ACADIAN AMBULANCE SERVICE OF TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF CONTRACTS
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-291-4039
Mailing Address - Street 1:PO BOX 92970
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70509-2970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2022 HUMBLE PLACE DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5281
Practice Address - Country:US
Practice Address - Phone:800-259-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACADIAN AMBULANCE SERVICE OF TEXAS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-24
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000848341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX267122Medicare UPIN