Active NPI
City of College Station
- Land Ambulance
- College Station, TX
National Provider Identifier
1891728465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 021004
- Legal business name
- CITY OF COLLEGE STATION
- Practice address
- 300 Krenek Tap Rd
College Station, TX 77840-5023 - Phone
- (979) 764-3705
- NPI assigned
- Jul 8, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joshua Varner
- Title
- Asst. EMS Chief
- Phone
- (979) 764-3705
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 021004 | TX | Primary |
Addresses
Primary practice location
300 Krenek Tap Rd
College Station, TX 77840-5023
Mailing address
PO Box 223783
Dallas, TX 75222-3783
Phone (979) 764-3705
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000 | Other | CO | CHAMPUS VA CENTER |
| 0000 | Other | WI | CHAMPUS FOUNDATION HEALTH |
| 000053101 | Medicaid | TX | |
| 505305 | Other | TX | CLAREDON CHIPS PROGRAM |
| 8541632 | Other | KY | AETNA |
| 8541632 | Other | TX | FEDERAL BLUE |
| 60054 | Other | TX | AETNA HEALTH PLANS OF TEX |
| 0000 | Other | SC | CHAMPUS RETIRED MILITARY |
| 000053101 | Other | VA | AMERIGROUP - MEDICAID |
| 505305 | Other | TX | BCBS |
| 0009728 | Other | NE | HARRIS METHODIST HEALTH P |
| 95266 | Other | CO | HARRINGTON BNEFITS SE |
| 103014100 | Other | TX | FIRST CARE HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091230000060 | TX | Part B Supplier - Ambulance Service Supplier | 1153461926 | Practice locations: College Station, TX |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1029068 | City of College Station Fire Dept | Certificate of waiver | Aug 9, 2026 |
National Provider Directory
National Provider DirectoryLocations
3105 Corsair Cir
College Station, TX 77845
Phone (979) 213-6105
1101 Texas Ave S
College Station, TX 77840
Phone (979) 764-3575
300 Krenek Tap Rd
College Station, TX 77840
Phone (409) 765-3568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767571200000",
"number": "1891728465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 223783",
"city": "DALLAS",
"state": "TX",
"postal_code": "752223783",
"telephone_number": "979-764-3705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 KRENEK TAP RD",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778405023",
"telephone_number": "979-764-3705"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF COLLEGE STATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-08",
"last_updated": "2026-01-05",
"certification_date": "2026-01-05",
"status": "A",
"authorized_official_last_name": "VARNER",
"authorized_official_first_name": "JOSHUA",
"authorized_official_title_or_position": "ASST. EMS CHIEF",
"authorized_official_telephone_number": "979-764-3705"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "TX",
"license": "021004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS VA CENTER",
"identifier": "0000",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS FOUNDATION HEALTH",
"identifier": "0000",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000053101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLAREDON CHIPS PROGRAM",
"identifier": "505305",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "8541632",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLUE",
"identifier": "8541632",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTH PLANS OF TEX",
"identifier": "60054",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS RETIRED MILITARY",
"identifier": "0000",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP - MEDICAID",
"identifier": "000053101",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "505305",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARRIS METHODIST HEALTH P",
"identifier": "0009728",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARRINGTON BNEFITS SE",
"identifier": "95266",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST CARE HMO",
"identifier": "103014100",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.