Organization
S TX LIFESTAR AMBULANCE SRVC
Active
Other names
LifeStar EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEYANIRA LOPEZ (PRESIDENT)
(956) 533-5485
Entity
Organization
Contact information
Practice address
4839 OLD ESCOBARES HWY 83, ROMA, TX 78584
(956) 847-1002
(956) 847-1317
Mailing address
PO BOX 808, ROMA, TX 78584-0808
(956) 847-1002
(956) 847-1317
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
214004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163777901
—
TX
Enumeration date
03/29/2007
Last updated
08/18/2008
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