Provider Demographics
NPI:1578620365
Name:TEXAS REGIONAL AMBULANCE SERVICE, LLC
Entity Type:Organization
Organization Name:TEXAS REGIONAL AMBULANCE SERVICE, LLC
Other - Org Name:TEXAS REGIONAL AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-434-5300
Mailing Address - Street 1:5334 PRUDENCE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-5117
Mailing Address - Country:US
Mailing Address - Phone:713-434-5300
Mailing Address - Fax:713-434-5304
Practice Address - Street 1:5334 PRUDENCE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-5117
Practice Address - Country:US
Practice Address - Phone:713-434-5300
Practice Address - Fax:713-434-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800220341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB593Medicare PIN