Provider Demographics
NPI:1457366569
Name:CITY OF LAMARQUE
Entity Type:Organization
Organization Name:CITY OF LAMARQUE
Other - Org Name:LAMARQUE FIRE RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-250-4141
Mailing Address - Street 1:1111 BAYOU RD
Mailing Address - Street 2:
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-4160
Mailing Address - Country:US
Mailing Address - Phone:409-938-9260
Mailing Address - Fax:409-935-1113
Practice Address - Street 1:1109A BAYOU RD
Practice Address - Street 2:
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-4160
Practice Address - Country:US
Practice Address - Phone:409-938-9261
Practice Address - Fax:409-935-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
TX8000953416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182245401Medicaid
TXAMB817OtherBC/BS OF TEXAS
P00296879OtherRAILROAD MEDICARE
P00296879OtherRAILROAD MEDICARE