Provider Demographics
NPI:1720008659
Name:CITY OF PEARLAND
Entity Type:Organization
Organization Name:CITY OF PEARLAND
Other - Org Name:CITY OF PEARLAND EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-997-5842
Mailing Address - Street 1:2703 VETERANS DRIVE
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1410
Mailing Address - Country:US
Mailing Address - Phone:888-978-6304
Mailing Address - Fax:888-972-9641
Practice Address - Street 1:2703 VETERANS DRIVE
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1410
Practice Address - Country:US
Practice Address - Phone:281-997-5842
Practice Address - Fax:800-353-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX020019341600000X, 341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000311301Medicaid
590004056OtherRAILROAD MEDICARE
TX513359OtherBC/BS OF TEXAS
TX513359Medicare PIN