Provider Demographics
NPI:1740258219
Name:CITY OF BURNET
Entity type:Organization
Organization Name:CITY OF BURNET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-715-3208
Mailing Address - Street 1:PO BOX 1369
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-7369
Mailing Address - Country:US
Mailing Address - Phone:512-756-2662
Mailing Address - Fax:512-456-4565
Practice Address - Street 1:104 S RHOMBERG
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-3205
Practice Address - Country:US
Practice Address - Phone:512-756-2662
Practice Address - Fax:512-756-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341600000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590001525OtherRAILROAD MEDICARE
TX000223001Medicaid
C19623Medicare UPIN
508463Medicare PIN