Provider Demographics
NPI:1215124821
Name:BLUE CREST AMBULANCE INC
Entity type:Organization
Organization Name:BLUE CREST AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELASSAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-526-5059
Mailing Address - Street 1:7900 WESTHEIMER RD
Mailing Address - Street 2:#137
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3091
Mailing Address - Country:US
Mailing Address - Phone:832-526-5059
Mailing Address - Fax:713-780-2214
Practice Address - Street 1:7900 WESTHEIMER RD
Practice Address - Street 2:#137
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3091
Practice Address - Country:US
Practice Address - Phone:832-526-5059
Practice Address - Fax:713-780-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10000643416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000064OtherAMBULANCE STATE LICENSE