Provider Demographics
NPI:1710981774
Name:METROPOLITAN AREA EMS AUTHORITY
Entity Type:Organization
Organization Name:METROPOLITAN AREA EMS AUTHORITY
Other - Org Name:MEDSTAR MOBILE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:JD NRP
Authorized Official - Phone:817-923-3700
Mailing Address - Street 1:2900 ALTA MERE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-4115
Mailing Address - Country:US
Mailing Address - Phone:817-923-3700
Mailing Address - Fax:817-632-0537
Practice Address - Street 1:2900 ALTA MERE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116
Practice Address - Country:US
Practice Address - Phone:817-923-3700
Practice Address - Fax:817-632-0537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220062341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088220101Medicaid
TX088220101Medicaid