Provider Demographics
NPI:1710923297
Name:MUSTANG EMS INC.
Entity Type:Organization
Organization Name:MUSTANG EMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:VALDIE
Authorized Official - Last Name:KIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-561-8322
Mailing Address - Street 1:13003 MURPHY RD
Mailing Address - Street 2:M-6
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3956
Mailing Address - Country:US
Mailing Address - Phone:281-561-8322
Mailing Address - Fax:281-561-8325
Practice Address - Street 1:13003 MURPHY RD
Practice Address - Street 2:M-6
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3956
Practice Address - Country:US
Practice Address - Phone:281-561-8322
Practice Address - Fax:281-561-8325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800068343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB784OtherBLUE CROSS BLUE SHIELD
TXAMB784OtherBLUE CROSS BLUE SHIELD