Provider Demographics
NPI:1699772004
Name:BEEVILLE ANGEL CARE AMBULANCE SERVICE, INC
Entity type:Organization
Organization Name:BEEVILLE ANGEL CARE AMBULANCE SERVICE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-358-6472
Mailing Address - Street 1:1105 W CORPUS CHRISTI ST
Mailing Address - Street 2:P. O. BOX 1293
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-5513
Mailing Address - Country:US
Mailing Address - Phone:361-358-6472
Mailing Address - Fax:361-358-6743
Practice Address - Street 1:1105 W CORPUS CHRISTI ST
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-5513
Practice Address - Country:US
Practice Address - Phone:361-358-6472
Practice Address - Fax:361-358-6473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0130033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0007585-01Medicaid
TX590014484OtherMEDICARE RAILROAD
TXAMB572OtherBLUE CROSS BLUE SHIELD
TX0007585-01Medicaid