City of Presidio

Primary specialty

AmbulanceTaxonomy code 341600000X

License

189003 Issued in TX

Legal business name

CITY OF PRESIDIO

Practice address

507 W O'Rieley St
Presidio, TX 79845

Phone

(432) 229-3517

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Marco A Baeza

Title

City of Presidio Administrator

Phone

(432) 229-3517

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1851582316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 W O'RIELEY ST",
            "city": "PRESIDIO",
            "state": "TX",
            "postal_code": "79845",
            "telephone_number": "432-229-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 W O'RIELEY ST",
            "city": "PRESIDIO",
            "state": "TX",
            "postal_code": "79845",
            "telephone_number": "432-229-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PRESIDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "BAEZA",
        "authorized_official_first_name": "MARCO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CITY OF PRESIDIO ADMINISTRATOR",
        "authorized_official_telephone_number": "432-229-3517"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "189003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1776262-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590004836",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aguirre Dental (Presidio County Dental Services)
• AMC Presidio Clinic
• Justin Lee Bejarano
• Health Hub Physicians Inc (Bravo Health Presidio)
• Health Hub Physicians Inc (Bravo Health Presidio)
• Victor Hugo Hernandez, M.ED.
• Mario Juarez
• Presidio Independent School District

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.