Provider Demographics
NPI:1265470165
Name:CITY OF WEST UNIVERSITY PLACE
Entity Type:Organization
Organization Name:CITY OF WEST UNIVERSITY PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-662-5837
Mailing Address - Street 1:3800 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST UNIVERSITY PLACE
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2802
Mailing Address - Country:US
Mailing Address - Phone:713-662-5836
Mailing Address - Fax:713-662-5303
Practice Address - Street 1:3800 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:WEST UNIVERSITY PLACE
Practice Address - State:TX
Practice Address - Zip Code:77005-2802
Practice Address - Country:US
Practice Address - Phone:713-662-5836
Practice Address - Fax:713-662-5303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1010633416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152175901Medicaid
TX101063OtherTDS EMS AMBULANCE LICENSE
TX505139OtherBLUECROSS NUMBER
TX505139OtherBLUECROSS NUMBER
TX152175901Medicaid