Provider Demographics
NPI:1679594568
Name:KENDALL COUNTY
Entity Type:Organization
Organization Name:KENDALL COUNTY
Other - Org Name:KENDALL COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-249-3721
Mailing Address - Street 1:7900 NW 154TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5816
Mailing Address - Country:US
Mailing Address - Phone:888-987-6179
Mailing Address - Fax:
Practice Address - Street 1:1175 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3002
Practice Address - Country:US
Practice Address - Phone:830-249-3721
Practice Address - Fax:830-249-7936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1300013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX504158OtherBC/BS OF TEXAS
TX086502401Medicaid
TX504158OtherBC/BS OF TEXAS
TX086502401Medicaid