Provider Demographics
NPI:1730127325
Name:RELIABLE AMBULANCE SERVICE OF LAREDO INC.
Entity Type:Organization
Organization Name:RELIABLE AMBULANCE SERVICE OF LAREDO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CANSECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-887-0262
Mailing Address - Street 1:PO BOX 440152
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78044-0152
Mailing Address - Country:US
Mailing Address - Phone:956-725-4461
Mailing Address - Fax:956-728-0112
Practice Address - Street 1:1820 MARCELLA AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-3957
Practice Address - Country:US
Practice Address - Phone:956-725-4461
Practice Address - Fax:956-728-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1780343416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
515802Medicare ID - Type Unspecified