Provider Demographics
NPI:1790079952
Name:ANSELM O IBE
Entity Type:Organization
Organization Name:ANSELM O IBE
Other - Org Name:A & A BRIGHT EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANSELM
Authorized Official - Middle Name:O
Authorized Official - Last Name:IBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-748-7171
Mailing Address - Street 1:9898 BISSONNET ST
Mailing Address - Street 2:375E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8270
Mailing Address - Country:US
Mailing Address - Phone:281-748-7171
Mailing Address - Fax:281-817-5904
Practice Address - Street 1:9898 BISSONNET ST
Practice Address - Street 2:375E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8270
Practice Address - Country:US
Practice Address - Phone:281-748-7171
Practice Address - Fax:281-817-5904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000605341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance