Provider Demographics
NPI:1508880253
Name:CITY OF BOWIE
Entity Type:Organization
Organization Name:CITY OF BOWIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-872-2122
Mailing Address - Street 1:304 LINDSEY ST
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:TX
Mailing Address - Zip Code:76230-4912
Mailing Address - Country:US
Mailing Address - Phone:940-872-2122
Mailing Address - Fax:940-872-6544
Practice Address - Street 1:203 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:TX
Practice Address - Zip Code:76230-4840
Practice Address - Country:US
Practice Address - Phone:940-872-2122
Practice Address - Fax:940-872-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1690063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000047301Medicaid
TX505146OtherBC/BS OF TEXAS
TX505146Medicare PIN
TX590000252Medicare PIN