Provider Demographics
NPI:1851485387
Name:MANVEL EMERGENCY MEDICAL SERVICES
Entity Type:Organization
Organization Name:MANVEL EMERGENCY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-489-6144
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578
Mailing Address - Country:US
Mailing Address - Phone:281-489-6144
Mailing Address - Fax:281-489-0024
Practice Address - Street 1:6931 MASTERS RD
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-4782
Practice Address - Country:US
Practice Address - Phone:281-489-6144
Practice Address - Fax:281-489-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0200403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000325301Medicaid
TX513611OtherBCBS PROVIDER NUMBER
TXP00235614OtherRAILROAD MEDICARE
TX000325301Medicaid
TX513611Medicare PIN