Organization
CITY OF MATHIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY T GENTILE (AUTHORIZED AGENT)
(860) 257-7080
Entity
Organization
Contact information
Practice address
411 E SAN PATRICIO AVE, MATHIS, TX 78368-2351
(361) 547-3995
(361) 547-4214
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(860) 257-7080
(860) 563-3403
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
205011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000502701
—
TX
01
—
590007414
RAILROAD
TX
Enumeration date
08/20/2006
Last updated
09/17/2013
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