Provider Demographics
NPI:1346388873
Name:CITY OF ROWLETT
Entity Type:Organization
Organization Name:CITY OF ROWLETT
Other - Org Name:ROWLETT FIRE RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FATTIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-412-6230
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-0099
Mailing Address - Country:US
Mailing Address - Phone:972-412-6231
Mailing Address - Fax:972-412-6243
Practice Address - Street 1:4000 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-5077
Practice Address - Country:US
Practice Address - Phone:972-412-6231
Practice Address - Fax:972-412-6243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0570673416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX507100OtherBLUE CROSS BLUE SHIELD
TX1346388873Medicaid
TX590000648OtherRAILROAD MEDICARE
TX507100Medicare PIN