Organization
CITY OF SHAVANO PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA MOREY (FINANCE DIRECTOR)
(210) 477-0960
Entity
Organization
Contact information
Practice address
15604 NW MILITARY HWY, SHAVANO PARK, TX 78231-1537
(210) 492-1111
(210) 492-5884
Mailing address
15604 NW MILITARY HWY, SHAVANO PARK, TX 78231-1537
(210) 492-1111
(210) 492-5884
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
015108
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171420601
—
TX
01
—
AMB418
MEDICARE PTAN
TX
Enumeration date
10/27/2005
Last updated
09/28/2023
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