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Organization

CANYON LAKE FIRE/EMS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SHAWN MICHAEL WHERRY FF/EMT-P (CHIEF)
(830) 907-2922
Entity
Organization

Contact information

Practice address
1425 SATTLER RD, CANYON LAKE, TX 78132-2213
(830) 907-2922
(830) 907-2408
Mailing address
PO BOX 2140, CANYON LAKE, TX 78133-0024
(830) 907-2922
(830) 907-2408

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
046001
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000027501
TX
Enumeration date
10/27/2005
Last updated
04/10/2009
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