Provider Demographics
NPI:1487042727
Name:WILSON COUNTY EMERGENCY SERVICES DISTRICT 3
Entity Type:Organization
Organization Name:WILSON COUNTY EMERGENCY SERVICES DISTRICT 3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:RICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:830-391-3448
Mailing Address - Street 1:PO BOX 691363
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1363
Mailing Address - Country:US
Mailing Address - Phone:281-397-0397
Mailing Address - Fax:281-397-6934
Practice Address - Street 1:111 S HWY 123 N
Practice Address - Street 2:
Practice Address - City:STOCKDALE
Practice Address - State:TX
Practice Address - Zip Code:78160
Practice Address - Country:US
Practice Address - Phone:830-996-3087
Practice Address - Fax:830-996-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000937341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3478190-02 CSHCNMedicaid
TX3478190-01Medicaid
TX3478190-02 CSHCNMedicaid