Provider Demographics
NPI:1467521492
Name:EAGLE PASS AMBULANCE LLC
Entity Type:Organization
Organization Name:EAGLE PASS AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELIPE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-773-0787
Mailing Address - Street 1:2320 DEL RIO BLVD
Mailing Address - Street 2:PMB 6
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-3624
Mailing Address - Country:US
Mailing Address - Phone:830-773-0787
Mailing Address - Fax:830-968-4910
Practice Address - Street 1:2320 DEL RIO BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-3624
Practice Address - Country:US
Practice Address - Phone:830-773-0787
Practice Address - Fax:830-968-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8001973416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport