Provider Demographics
NPI:1235464348
Name:DELTA EMERGENCY SERVICE LLC
Entity Type:Organization
Organization Name:DELTA EMERGENCY SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:IGWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:281-513-2725
Mailing Address - Street 1:15807 CERCA BLANCA DR STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-4935
Mailing Address - Country:US
Mailing Address - Phone:281-513-2725
Mailing Address - Fax:281-277-6808
Practice Address - Street 1:15807 CERCA BLANCA DR STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-4935
Practice Address - Country:US
Practice Address - Phone:281-513-2725
Practice Address - Fax:281-277-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance