Provider Demographics
NPI:1497187702
Name:ST. LOUIS ANGELS LLC
Entity Type:Organization
Organization Name:ST. LOUIS ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-224-6198
Mailing Address - Street 1:126 ELI ST
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-6646
Mailing Address - Country:US
Mailing Address - Phone:956-224-6198
Mailing Address - Fax:956-847-4472
Practice Address - Street 1:126 ELI ST
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-6646
Practice Address - Country:US
Practice Address - Phone:956-224-6198
Practice Address - Fax:956-847-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10009023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport