Provider Demographics
NPI:1104931278
Name:CITY OF EAGLE PASS
Entity type:Organization
Organization Name:CITY OF EAGLE PASS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-757-2698
Mailing Address - Street 1:2558 EL INDIO HWY
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5555
Mailing Address - Country:US
Mailing Address - Phone:830-757-4231
Mailing Address - Fax:830-757-9152
Practice Address - Street 1:2558 EL INDIO HWY
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5555
Practice Address - Country:US
Practice Address - Phone:830-757-4231
Practice Address - Fax:830-757-9152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1620013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086535401Medicaid
TX086535401Medicaid