Provider Demographics
NPI:1437423175
Name:SWONKE, WILLIAM LESTER (PARAMEDIC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LESTER
Last Name:SWONKE
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22323 FM 149 RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-4525
Mailing Address - Country:US
Mailing Address - Phone:713-252-9311
Mailing Address - Fax:281-288-7070
Practice Address - Street 1:22323 FM 149 RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-4525
Practice Address - Country:US
Practice Address - Phone:713-252-9311
Practice Address - Fax:281-288-7070
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800142146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1839623Medicaid
TXAMB530Medicare PIN