Provider Demographics
NPI:1962664524
Name:CAMINO REAL AMBULANCE INC.
Entity Type:Organization
Organization Name:CAMINO REAL AMBULANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESEQUIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-876-0066
Mailing Address - Street 1:PO BOX 1653
Mailing Address - Street 2:
Mailing Address - City:CARRIZO SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78834-7653
Mailing Address - Country:US
Mailing Address - Phone:830-876-0066
Mailing Address - Fax:830-876-0072
Practice Address - Street 1:403 E NOPAL ST STE A
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834-3333
Practice Address - Country:US
Practice Address - Phone:830-876-0066
Practice Address - Fax:830-876-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10001443416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport