Provider Demographics
NPI:1740202738
Name:CITY OF VAN ALSTYNE
Entity Type:Organization
Organization Name:CITY OF VAN ALSTYNE
Other - Org Name:VAN ALSTYNE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SMITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-482-6666
Mailing Address - Street 1:PO BOX 495548
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75049-5548
Mailing Address - Country:US
Mailing Address - Phone:855-270-2499
Mailing Address - Fax:214-503-7135
Practice Address - Street 1:280 NORTH PRESTON
Practice Address - Street 2:
Practice Address - City:VAN ALSTYNE
Practice Address - State:TX
Practice Address - Zip Code:75495
Practice Address - Country:US
Practice Address - Phone:903-482-6666
Practice Address - Fax:903-712-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300549341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155929601Medicaid
P00011975OtherRAILROAD MEDICARE
TXAMB680OtherBC/BS OF TEXAS
TXAMB680OtherBC/BS OF TEXAS