Organization
SPACE CITY EMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA FONSECA (OWNER)
(713) 944-4667
Entity
Organization
Contact information
Practice address
7999 HANSEN RD STE 308, HOUSTON, TX 77061-3450
(713) 944-4667
(713) 946-4888
Mailing address
7999 HANSEN RD STE 308, HOUSTON, TX 77061-3450
(713) 944-4667
(713) 946-4888
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
800204
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800204
PROVIDER STATE LICENSE
TX
Enumeration date
12/06/2006
Last updated
08/22/2020
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