City of Texas City

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

300076 Issued in TX

Legal business name

CITY OF TEXAS CITY

Doing business as

City of Texas City EMS

Practice address

1725 25TH Street N
Texas City, TX 77590

Phone

(409) 643-5705

Fax

(409) 643-5719

NPI assigned

Jun 6, 2006

Last updated

Dec 31, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Wendell E Wiley II, CAPTAIN

Title

EMS Administrator

Phone

(409) 643-5705

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• City of Texas City EMS 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": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1831138775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 25TH STREET N",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "77590",
            "telephone_number": "409-643-5705",
            "fax_number": "409-643-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 25TH STREET N",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "77590",
            "telephone_number": "409-643-5705",
            "fax_number": "409-643-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF TEXAS CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EMS ADMINISTRATOR",
        "authorized_official_telephone_number": "409-643-5705",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "CAPTAIN"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "300076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1773814",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Texas City EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emergency Medical Services (Emergency Medicine) Physician in Texas City, TX
• Providers in Texas City, TX by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.