Provider Demographics
NPI:1083675250
Name:CITY OF LOCKHART
Entity Type:Organization
Organization Name:CITY OF LOCKHART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-398-7320
Mailing Address - Street 1:214 BUFKIN LANE
Mailing Address - Street 2:
Mailing Address - City:LOCKHART
Mailing Address - State:TX
Mailing Address - Zip Code:78644
Mailing Address - Country:US
Mailing Address - Phone:512-398-7320
Mailing Address - Fax:512-398-3393
Practice Address - Street 1:214 BUFKIN LANE
Practice Address - Street 2:
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644
Practice Address - Country:US
Practice Address - Phone:512-398-7320
Practice Address - Fax:512-398-3393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX028006341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
504310Medicare ID - Type Unspecified