Provider Demographics
NPI:1225010291
Name:CITY OF EL CAMPO
Entity Type:Organization
Organization Name:CITY OF EL CAMPO
Other - Org Name:EL CAMPO EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRET
Authorized Official - Middle Name:
Authorized Official - Last Name:BUBELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-543-3335
Mailing Address - Street 1:PO BOX 4897 DEPT #569
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4897
Mailing Address - Country:US
Mailing Address - Phone:855-626-9660
Mailing Address - Fax:833-953-0588
Practice Address - Street 1:1011 WEST LOOP
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-9480
Practice Address - Country:US
Practice Address - Phone:979-543-3335
Practice Address - Fax:979-541-5062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX241002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590001000OtherPALMETTO
TX086374801Medicaid
590001000OtherPALMETTO
TX086374801Medicaid