Provider Demographics
NPI:1437376332
Name:CITY OF QUITAQUE
Entity Type:Organization
Organization Name:CITY OF QUITAQUE
Other - Org Name:QUITAQUE VOL. AMB. SERV.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-455-1456
Mailing Address - Street 1:PO BOX 721648
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77272-1648
Mailing Address - Country:US
Mailing Address - Phone:713-773-4355
Mailing Address - Fax:713-773-4362
Practice Address - Street 1:222 MAIN ST
Practice Address - Street 2:
Practice Address - City:QUITAQUE
Practice Address - State:TX
Practice Address - Zip Code:79255
Practice Address - Country:US
Practice Address - Phone:713-773-4355
Practice Address - Fax:713-773-4362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX023001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB179OtherMEDICARE
TX161479401Medicaid
TX161479401Medicaid