Provider Demographics
NPI:1992863815
Name:CITY OF TEXICO
Entity Type:Organization
Organization Name:CITY OF TEXICO
Other - Org Name:TEXICO VOLUNTEER FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-482-3314
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:TEXICO
Mailing Address - State:NM
Mailing Address - Zip Code:88135-0208
Mailing Address - Country:US
Mailing Address - Phone:505-482-3314
Mailing Address - Fax:505-482-9044
Practice Address - Street 1:120 N. TURNER
Practice Address - Street 2:
Practice Address - City:TEXICO
Practice Address - State:NM
Practice Address - Zip Code:88135-0208
Practice Address - Country:US
Practice Address - Phone:505-482-3314
Practice Address - Fax:505-482-9044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF TEXICO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-04
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM525703416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR5744Medicaid
NMR5744Medicaid