Pecos County

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1000189 Issued in TX

Legal business name

PECOS COUNTY

Practice address

310 W 5TH Street
Fort Stockton, TX 79735

Phone

(432) 336-3062

Fax

(432) 336-4645

NPI assigned

Sep 18, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Joe Shuster

Title

County Judge, Pecos County

Phone

(432) 336-2792

Specialties & licenses 1

Addresses

Other names 1

• Pecos County Emergency Medical Service Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1346499902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W CALLAGHAN ST",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797357101",
            "telephone_number": "432-336-3062",
            "fax_number": "432-336-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W 5TH STREET",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-3062",
            "fax_number": "432-336-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECOS COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "SHUSTER",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "COUNTY JUDGE, PECOS COUNTY",
        "authorized_official_telephone_number": "432-336-2792",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "1000189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pecos County Emergency Medical Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Justin Obunike Olisaemeka
• Hulon Houston Pass, O.D.
• Joshua Robert Pass, O.D.
• Paris Patel, DMD
• Shashwatkumar Patel, PHARM D
• Pecos County Community Action Agency Inc.
• Pecos County Memorial
• Pecos County Memorial Hospital
• Pecos County Memorial Hospital
• Pecos County Memorial Hospital

• Land Ambulance in Fort Stockton, TX
• Providers in Fort Stockton, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.