Organization
CODE 4 EMERGENCY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN BRADLEY LP (VICE PRESIDENT)
(888) 912-6334
Entity
Organization
Contact information
Practice address
1901 E 51ST ST, AUSTIN, TX 78723-3040
(888) 912-6334
(888) 912-6334
Mailing address
1901 E 51ST ST, AUSTIN, TX 78723-3040
(888) 912-6334
(888) 912-6334
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
291U00000X
Clinical Medical Laboratory
—
—
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30471
COLA
—
01
—
45D2190889
CLIA
—
01
—
800923
DSHS FRO
TX
Enumeration date
09/01/2020
Last updated
03/07/2023
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