Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 341600000X | Ambulance | | 300189 | TEXAS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 47240 | OTHER | TEXAS | HMO BLUE STAR PLUS 81053 |
| 2 | 1014892 | OTHER | TEXAS | AETNA 1125 |
| 3 | 300189 | OTHER | TEXAS | ESIS 419310 |
| 4 | 300128 | OTHER | TEXAS | TEXAS MUTUAL 12029 |
| 5 | 0070831 | OTHER | TEXAS | BC BS OF TN 180150 |
| 6 | 41527 | OTHER | TEXAS | CHIPS AMERIKIDS 62947 |
| 7 | 107752101 | MEDICAID | TEXAS | |
| 8 | XMTE06119 | OTHER | CALIFORNIA | CAID SAN MATEO CA |
| 9 | 503724 | MEDICARE ID-TYPE UNSPECIFIED | TEXAS | EMS PROVIDER NUMBER |
| 10 | AMB300189 | OTHER | TEXAS | TEXAS MUTUAL 841843 |
| 11 | 296743 | OTHER | PENNSYLVANIA | BC BS OF PA 898845 |
| 12 | 590006512 | OTHER | TEXAS | RR MCARE 10066 |
