Provider Demographics
NPI:1902827108
Name:CITY OF PORT ISABEL
Entity Type:Organization
Organization Name:CITY OF PORT ISABEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPISTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-943-2682
Mailing Address - Street 1:110 W HICKMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ISABEL
Mailing Address - State:TX
Mailing Address - Zip Code:78578-2906
Mailing Address - Country:US
Mailing Address - Phone:956-943-2682
Mailing Address - Fax:956-943-2029
Practice Address - Street 1:110 W HICKMAN AVE
Practice Address - Street 2:
Practice Address - City:PORT ISABEL
Practice Address - State:TX
Practice Address - Zip Code:78578-2906
Practice Address - Country:US
Practice Address - Phone:956-943-2682
Practice Address - Fax:956-943-2029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0310043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX503648Medicare PIN