Provider Demographics
NPI:1780710731
Name:CITY OF CEDAR PARK
Entity type:Organization
Organization Name:CITY OF CEDAR PARK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-397-0397
Mailing Address - Street 1:PO BOX 691363
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1363
Mailing Address - Country:US
Mailing Address - Phone:281-397-0397
Mailing Address - Fax:281-397-6934
Practice Address - Street 1:450 CYPRESS CREEK RD
Practice Address - Street 2:BUILDING 3
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4194
Practice Address - Country:US
Practice Address - Phone:512-401-5220
Practice Address - Fax:512-260-2464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246012146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID #