Provider Demographics
NPI:1184100554
Name:BAAXTEN AMBULANCE LLC
Entity type:Organization
Organization Name:BAAXTEN AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR OF RECORD
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-520-8520
Mailing Address - Street 1:1221 E 10TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4282
Mailing Address - Country:US
Mailing Address - Phone:956-520-8520
Mailing Address - Fax:956-647-5344
Practice Address - Street 1:1221 E 10TH ST STE 107
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4282
Practice Address - Country:US
Practice Address - Phone:956-520-8520
Practice Address - Fax:956-647-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000986341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000986OtherDEPARTMENT OF STATE HEALTH SERVICES