City of Bryan

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

021006 Issued in TX

Legal business name

CITY OF BRYAN

Practice address

300 South Texas Ave
Bryan, TX 77803-3226

Phone

(979) 209-5080

Fax

(979) 209-5095

NPI assigned

Apr 21, 2006

Organization subpart

No

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

Authorized official

Name

Cory Matthews

Title

EMS Chief

Phone

(979) 209-5970

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• City of Bryan Ambulance Service 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": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1831155647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1000",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778051000",
            "telephone_number": "979-209-5080",
            "fax_number": "979-209-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SOUTH TEXAS AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778033226",
            "telephone_number": "979-209-5080",
            "fax_number": "979-209-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BRYAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "EMS CHIEF",
        "authorized_official_telephone_number": "979-209-5970"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "021006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000117401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Bryan Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "City of Bryan Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Christian, LMSW
• Christus Continuing Care
• Abbey Ann CHRZ, PT, DPT
• Kuo-Hong Chuang
• Jim Hudson Chung, M.D.
• Annette M Clark, LICSW
• Jennifer Bowlin Clark, COTA
• Joan Marie Clark, L.P.C.
• Katie Louise Clark, RN
• Brenda Kay Clarke, FNP-C

• Land Ambulance in Bryan, TX
• Providers in Bryan, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.