Provider Demographics
NPI:1750676870
Name:ACADIAN AMBULANCE SERVICE OF TEXAS LLC
Entity Type:Organization
Organization Name:ACADIAN AMBULANCE SERVICE OF TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF CONTRACTS
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-291-4039
Mailing Address - Street 1:PO BOX 92970
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70509-2970
Mailing Address - Country:US
Mailing Address - Phone:800-259-3333
Mailing Address - Fax:337-291-4252
Practice Address - Street 1:3720 CORLEY ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-6431
Practice Address - Country:US
Practice Address - Phone:800-259-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000848341600000X
341600000X
TX8001533416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3185332Medicaid
TX267122Medicare PIN