Provider Demographics
NPI:1275613861
Name:USA AMBULANCE SERVICE
Entity Type:Organization
Organization Name:USA AMBULANCE SERVICE
Other - Org Name:USA AMBULANCE SERVICE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORESIA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:GOREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-646-4780
Mailing Address - Street 1:8015 OXFORDSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4671
Mailing Address - Country:US
Mailing Address - Phone:832-646-4780
Mailing Address - Fax:281-379-1657
Practice Address - Street 1:13940 BAMMEL NORTH HOUSTON RD
Practice Address - Street 2:SUITE 230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-2958
Practice Address - Country:US
Practice Address - Phone:281-537-0485
Practice Address - Fax:281-537-8478
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:USA AMBULANCE SERVICE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-17
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0790053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164651501Medicaid
TXAMB312Medicare ID - Type UnspecifiedMEDICARE PART B