Organization
YORKTOWN EMERGENCY MEDICAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILLIAM GREEN (AOR)
(361) 938-7080
Entity
Organization
Contact information
Practice address
508 N RIEDEL ST, YORKTOWN, TX 78164-1810
(361) 564-9410
(361) 564-9476
Mailing address
PO BOX 142, YORKTOWN, TX 78164-0142
(361) 564-9410
(361) 564-9476
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
062008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000404601
—
TX
01
—
062008
TDH LICENSE NUMBER
TX
01
—
514705
BCBS PROVIDER NUMBER
TX
Enumeration date
05/23/2005
Last updated
03/27/2018
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