Provider Demographics
NPI:1821413840
Name:BULVERDE-SPRING BRANCH EMS
Entity Type:Organization
Organization Name:BULVERDE-SPRING BRANCH EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUTHWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-228-4501
Mailing Address - Street 1:353 RODEO DR
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6257
Mailing Address - Country:US
Mailing Address - Phone:830-228-4501
Mailing Address - Fax:
Practice Address - Street 1:353 RODEO DR
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6257
Practice Address - Country:US
Practice Address - Phone:830-228-4501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0146003341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance