Provider Demographics
NPI:1376567040
Name:CITY OF PILOT POINT
Entity Type:Organization
Organization Name:CITY OF PILOT POINT
Other - Org Name:PILOT POINT AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAKONAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-686-5038
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-0457
Mailing Address - Country:US
Mailing Address - Phone:940-686-5038
Mailing Address - Fax:940-686-2222
Practice Address - Street 1:110 WEST DIVISION ST.
Practice Address - Street 2:
Practice Address - City:PILOT POINT
Practice Address - State:TX
Practice Address - Zip Code:76258
Practice Address - Country:US
Practice Address - Phone:940-686-5038
Practice Address - Fax:940-686-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX610183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000150501Medicaid
TX507047OtherBC/BS OF TEXAS
TX507047OtherBC/BS OF TEXAS
TX507047Medicare PIN