Provider Demographics
NPI:1013943398
Name:PEARL AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:PEARL AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:VENCE
Authorized Official - Last Name:KIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-781-9000
Mailing Address - Street 1:PO BOX 741711
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77274-1711
Mailing Address - Country:US
Mailing Address - Phone:713-781-9000
Mailing Address - Fax:281-983-9561
Practice Address - Street 1:13003 MURPHY RD
Practice Address - Street 2:L1
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3956
Practice Address - Country:US
Practice Address - Phone:713-781-9000
Practice Address - Fax:281-983-9561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB517OtherBLUE CROSS BLUE SHIELD
TXAMB003Medicare ID - Type Unspecified