Provider Demographics
NPI:1225325434
Name:SOUTH PADRE ISLAND FIRE/EMS
Entity Type:Organization
Organization Name:SOUTH PADRE ISLAND FIRE/EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:BURNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BASKET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-650-0953
Mailing Address - Street 1:110 W. VENUS
Mailing Address - Street 2:
Mailing Address - City:SOUTH PADRE ISLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78597
Mailing Address - Country:US
Mailing Address - Phone:972-650-0953
Mailing Address - Fax:972-650-2033
Practice Address - Street 1:4601 PADRE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH PADRE ISLAND
Practice Address - State:TX
Practice Address - Zip Code:78597-7325
Practice Address - Country:US
Practice Address - Phone:972-650-0953
Practice Address - Fax:972-650-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341600000X, 3416L0300X, 3416S0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
No3416S0300XTransportation ServicesAmbulanceWater Transport