Organization
MAURICE SHANER II
Active
Other names
Amb -Trans Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAURICE E SHANER II (OWNER)
(210) 734-3402
Entity
Organization
Contact information
Practice address
538 W WOODLAWN AVE, SAN ANTONIO, TX 78212-3345
(210) 734-3402
Mailing address
538 W WOODLAWN AVE, SAN ANTONIO, TX 78212-3345
(210) 734-3402
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
015094
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000741101
—
TX
01
—
AMB552
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/11/2006
Last updated
10/27/2020
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