Provider Demographics
NPI:1417977356
Name:SOUTHEAST VOLUNTEER FIRE DEPARTMENT
Entity type:Organization
Organization Name:SOUTHEAST VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-309-4594
Mailing Address - Street 1:PO BOX 224783
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-4783
Mailing Address - Country:US
Mailing Address - Phone:832-309-4594
Mailing Address - Fax:800-353-2196
Practice Address - Street 1:10510 SCARSDALE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-5734
Practice Address - Country:US
Practice Address - Phone:832-309-4594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1417977356Medicaid
TX515284OtherBC/BS OF TEXAS
TX515284OtherBC/BS OF TEXAS