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Organization
CITY OF PRESIDIO
Active
Organization
CITY OF PRESIDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCO A BAEZA (CITY OF PRESIDIO ADMINISTRATOR)
(432) 229-3517
Entity
Organization
Contact information
Practice address
507 W O'RIELEY ST, PRESIDIO, TX 79845
(432) 229-3517
Mailing address
507 W O'RIELEY ST, PRESIDIO, TX 79845
(432) 229-3517
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
189003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1776262-01
—
TX
01
—
590004836
RAILROAD MEDICARE
TX
Enumeration date
08/08/2007
Last updated
11/24/2015
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