Provider Demographics
NPI:1891870168
Name:CITY OF LEON VALLEY
Entity Type:Organization
Organization Name:CITY OF LEON VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-684-3219
Mailing Address - Street 1:6400 EL VERDE RD
Mailing Address - Street 2:
Mailing Address - City:LEON VALLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78238-2322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6400 EL VERDE RD
Practice Address - Street 2:
Practice Address - City:LEON VALLEY
Practice Address - State:TX
Practice Address - Zip Code:78238-2322
Practice Address - Country:US
Practice Address - Phone:210-684-3219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015034341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000406101Medicaid
TX590006639OtherRAILROAD MEDICARE
TX590006639OtherRAILROAD MEDICARE