Provider Demographics
NPI:1407960180
Name:CITIZENS EMERGENCY MEDICAL SERVICE INC.
Entity Type:Organization
Organization Name:CITIZENS EMERGENCY MEDICAL SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HUDMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:325-893-1074
Mailing Address - Street 1:PO BOX 1556
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:TX
Mailing Address - Zip Code:79510-1556
Mailing Address - Country:US
Mailing Address - Phone:325-893-5754
Mailing Address - Fax:325-893-4127
Practice Address - Street 1:815 S. SECOND
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:TX
Practice Address - Zip Code:79510-0000
Practice Address - Country:US
Practice Address - Phone:325-893-5754
Practice Address - Fax:325-893-4127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX030001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000739-01Medicaid
TXMC1339755Medicare UPIN