South Texas Ambulance Response, Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

800022 Issued in TX

Legal business name

SOUTH TEXAS AMBULANCE RESPONSE, INC

Doing business as

Revive Mobile Health

Practice address

12285 Pellicano Dr Ste A2
El Paso, TX 79936-6284

Phone

(915) 800-1052

Fax

(210) 971-9468

NPI assigned

Apr 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carlos Alarcon

Title

Owner

Phone

(915) 800-1082

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Revive Mobile Health Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1144286683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12285 PELLICANO DR STE A2",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366284",
            "telephone_number": "915-800-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12285 PELLICANO DR STE A2",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366284",
            "telephone_number": "915-800-1052",
            "fax_number": "210-971-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS AMBULANCE RESPONSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "ALARCON",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-800-1082"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "800022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175711401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Mobile Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in El Paso, TX
• Providers in El Paso, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.