Provider Demographics
NPI:1316198799
Name:AMERISTAR LLC
Entity Type:Organization
Organization Name:AMERISTAR LLC
Other - Org Name:AMERISTAR EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:LAQUESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-303-8525
Mailing Address - Street 1:9888 BISSONNET ST
Mailing Address - Street 2:SUITE 450B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8247
Mailing Address - Country:US
Mailing Address - Phone:713-303-8525
Mailing Address - Fax:281-265-1040
Practice Address - Street 1:9888 BISSONNET ST
Practice Address - Street 2:SUITE 450B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8247
Practice Address - Country:US
Practice Address - Phone:713-303-8525
Practice Address - Fax:281-265-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10001733416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000173OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES
TX198477501Medicaid
TXAMB1008OtherBCBS
TXAMB1008OtherBCBS