Provider Demographics
NPI:1326084724
Name:MP AMBULANCE SERVICE INC.
Entity Type:Organization
Organization Name:MP AMBULANCE SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-723-6001
Mailing Address - Street 1:13360 S GESSNER RD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-1022
Mailing Address - Country:US
Mailing Address - Phone:713-723-6001
Mailing Address - Fax:
Practice Address - Street 1:13360 S GESSNER RD
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-1022
Practice Address - Country:US
Practice Address - Phone:713-723-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1012753416L0300X
TX343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB634OtherBLUE CROSS BLUE SHIELD
TX149131801Medicaid
TXAMB634OtherBLUE CROSS BLUE SHIELD