Provider Demographics
NPI:1396842019
Name:BROOKSHIRE PATTISON AREA VOLUNTEER EMERGENCY AMBULANCE CORP
Entity Type:Organization
Organization Name:BROOKSHIRE PATTISON AREA VOLUNTEER EMERGENCY AMBULANCE CORP
Other - Org Name:BROOKSHIRE PATTISON EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-375-8500
Mailing Address - Street 1:PO BOX 908
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-0908
Mailing Address - Country:US
Mailing Address - Phone:281-375-8500
Mailing Address - Fax:281-934-4866
Practice Address - Street 1:911 GRESHAM
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423
Practice Address - Country:US
Practice Address - Phone:281-375-8500
Practice Address - Fax:281-934-4866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000504752OtherBLUE CROSS BLUE SHIELD
ILH0000504752OtherBLUE CROSS BLUE SHIELD
TX0000504752OtherBLUE CROSS BLUE SHIELD