Provider Demographics
NPI:1184961823
Name:DILLEY AMBULANCE SERVICE, INC
Entity type:Organization
Organization Name:DILLEY AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-965-6891
Mailing Address - Street 1:217 W MILLER ST
Mailing Address - Street 2:
Mailing Address - City:DILLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78017-3819
Mailing Address - Country:US
Mailing Address - Phone:830-965-6891
Mailing Address - Fax:830-965-6891
Practice Address - Street 1:1118 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78042
Practice Address - Country:US
Practice Address - Phone:956-220-0821
Practice Address - Fax:956-269-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10005133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport