Provider Demographics
NPI:1114319332
Name:VILLA AMBULANCE SERVICES LLC
Entity type:Organization
Organization Name:VILLA AMBULANCE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BALDOMERO
Authorized Official - Middle Name:
Authorized Official - Last Name:BONDOC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-568-2916
Mailing Address - Street 1:1819 SAN EDUARDO
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-3854
Mailing Address - Country:US
Mailing Address - Phone:956-568-2916
Mailing Address - Fax:956-441-0177
Practice Address - Street 1:1819 SAN EDUARDO AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-3854
Practice Address - Country:US
Practice Address - Phone:956-568-2916
Practice Address - Fax:956-441-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2024-08-14
Deactivation Date:2024-05-30
Deactivation Code:
Reactivation Date:2024-06-17
Provider Licenses
StateLicense IDTaxonomies
TX1000603341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance