Provider Demographics
NPI:1619348232
Name:FIRST RESPONSE MEDICAL TRAINING
Entity Type:Organization
Organization Name:FIRST RESPONSE MEDICAL TRAINING
Other - Org Name:FIRST RESPONSE MEDICAL EXAMS
Other - Org Type:Other Name
Authorized Official - Title/Position:PA
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:254-247-0460
Mailing Address - Street 1:2904 TRIMMIER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6038
Mailing Address - Country:US
Mailing Address - Phone:254-247-0460
Mailing Address - Fax:254-245-8899
Practice Address - Street 1:2904 TRIMMIER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6038
Practice Address - Country:US
Practice Address - Phone:254-247-0460
Practice Address - Fax:254-245-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty