Providence EMS LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

800100 Issued in TX

Legal business name

PROVIDENCE EMS LLC

Practice address

12807 Leader St
Houston, TX 77072-2121

Phone

(281) 498-2959

Fax

(713) 669-1091

NPI assigned

Jul 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ronnie Hayden

Title

Owner

Phone

(281) 498-2959

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1225067911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12807 LEADER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770722121",
            "telephone_number": "281-498-2959",
            "fax_number": "713-669-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12807 LEADER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770722121",
            "telephone_number": "281-498-2959",
            "fax_number": "713-669-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "HAYDEN",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-498-2959",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "800100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AMB835",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providence ER of Clearlake, PLLC (Houston Medical ER)
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• Providence Everly Haven Home Healthcare, LLC
• Providence Family Practice PA
• Providence Healthcare of TX (PHT Heal)

• Ambulance in Houston, TX
• Providers in Houston, TX by specialty
• Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.