Provider Demographics
NPI:1881916567
Name:ASTRO AMBULANCE MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:ASTRO AMBULANCE MEDICAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INTITIAL REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-866-1770
Mailing Address - Street 1:5645 HILLCROFT ST
Mailing Address - Street 2:# 607
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2296
Mailing Address - Country:US
Mailing Address - Phone:281-866-1770
Mailing Address - Fax:281-888-5077
Practice Address - Street 1:5645 HILLCROFT ST
Practice Address - Street 2:# 607
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2289
Practice Address - Country:US
Practice Address - Phone:281-866-1770
Practice Address - Fax:281-888-5077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000377146N00000X, 343900000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX21563401Medicaid
TX21563401Medicaid