Provider Demographics
NPI:1568534360
Name:AMERICAN MEDICAL SERVICE INC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:PICAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-293-4242
Mailing Address - Street 1:2875 JIMMY JOHNSON BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-2002
Mailing Address - Country:US
Mailing Address - Phone:409-293-4242
Mailing Address - Fax:409-853-1108
Practice Address - Street 1:2875 JIMMY JOHNSON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-2002
Practice Address - Country:US
Practice Address - Phone:409-293-4242
Practice Address - Fax:409-853-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1872174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084300501Medicaid
TX00N76AMedicare PIN
TXB21798Medicare UPIN