Provider Demographics
NPI:1649505140
Name:BRAZOS EVENT EMS LLC
Entity type:Organization
Organization Name:BRAZOS EVENT EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOYNAERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-229-5886
Mailing Address - Street 1:4108 POMEL DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-6148
Mailing Address - Country:US
Mailing Address - Phone:979-229-5886
Mailing Address - Fax:
Practice Address - Street 1:17529 HIGHWAY 6 S
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8465
Practice Address - Country:US
Practice Address - Phone:979-229-5886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000239OtherTDH LICENSE