Provider Demographics
NPI:1982624805
Name:CITY OF BELLAIRE
Entity type:Organization
Organization Name:CITY OF BELLAIRE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:DEACON
Authorized Official - Last Name:TITTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-662-8201
Mailing Address - Street 1:PO BOX 222013
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-2013
Mailing Address - Country:US
Mailing Address - Phone:713-662-8202
Mailing Address - Fax:713-662-8199
Practice Address - Street 1:5101 JESSAMINE ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4446
Practice Address - Country:US
Practice Address - Phone:713-662-8201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1010923416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX507185OtherBC/BS OF TEXAS
TX140461801Medicaid
TX507185Medicare PIN
TX590900140Medicare PIN