Provider Demographics
NPI:1184643850
Name:CITY OF PORT ARANSAS
Entity type:Organization
Organization Name:CITY OF PORT ARANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-438-4413
Mailing Address - Street 1:705 W AVENUE A
Mailing Address - Street 2:
Mailing Address - City:PORT ARANSAS
Mailing Address - State:TX
Mailing Address - Zip Code:78373-4112
Mailing Address - Country:US
Mailing Address - Phone:361-749-4405
Mailing Address - Fax:361-749-4490
Practice Address - Street 1:628 W AVENUE A
Practice Address - Street 2:
Practice Address - City:PORT ARANSAS
Practice Address - State:TX
Practice Address - Zip Code:78373-4100
Practice Address - Country:US
Practice Address - Phone:361-749-4405
Practice Address - Fax:361-749-4490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX178020341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178020OtherDSHS
TX1184643850Medicaid
TX0001067-01Medicaid