Provider Demographics
NPI:1851317150
Name:NEW LIFE AMBULANCE SERVICE
Entity Type:Organization
Organization Name:NEW LIFE AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:281-709-5697
Mailing Address - Street 1:PO BOX 682902
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77268
Mailing Address - Country:US
Mailing Address - Phone:281-709-5697
Mailing Address - Fax:
Practice Address - Street 1:30 LYERLY
Practice Address - Street 2:STE 2
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022
Practice Address - Country:US
Practice Address - Phone:713-691-7077
Practice Address - Fax:713-691-7417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015102341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150332801Medicaid
TXAMB632OtherBLUE CROSS
TXAMB192Medicare ID - Type Unspecified