Provider Demographics
NPI:1457322885
Name:FORT BEND COUNTY
Entity Type:Organization
Organization Name:FORT BEND COUNTY
Other - Org Name:FORT BEND COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-633-7096
Mailing Address - Street 1:5855 SIENNA SPRINGS WAY STE 208
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7399
Mailing Address - Country:US
Mailing Address - Phone:281-633-7092
Mailing Address - Fax:281-633-7060
Practice Address - Street 1:4332 HIGHWAY 36 S
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-9108
Practice Address - Country:US
Practice Address - Phone:281-633-7085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086395301Medicaid
TX086395301Medicaid