Provider Demographics
NPI:1487604195
Name:MEDIC ONE CORPORATION
Entity type:Organization
Organization Name:MEDIC ONE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LESTER
Authorized Official - Last Name:SWONKE
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:713-252-9311
Mailing Address - Street 1:22323 FM 149 RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-4525
Mailing Address - Country:US
Mailing Address - Phone:713-252-9311
Mailing Address - Fax:281-288-7070
Practice Address - Street 1:2810 LOUETTA RD
Practice Address - Street 2:#9
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4648
Practice Address - Country:US
Practice Address - Phone:713-252-9311
Practice Address - Fax:281-288-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800142341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX800142OtherEMS PROVIDER LICENSE