Provider Demographics
NPI:1750466033
Name:NUECES COUNTY RURAL FIRE DISTRICT NO 4
Entity type:Organization
Organization Name:NUECES COUNTY RURAL FIRE DISTRICT NO 4
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUNTZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-960-8921
Mailing Address - Street 1:PO BOX 260176
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78426-0176
Mailing Address - Country:US
Mailing Address - Phone:361-387-4066
Mailing Address - Fax:361-387-7117
Practice Address - Street 1:5781 FM 666
Practice Address - Street 2:
Practice Address - City:ROBSTOWN
Practice Address - State:TX
Practice Address - Zip Code:78380-5246
Practice Address - Country:US
Practice Address - Phone:361-387-4066
Practice Address - Fax:361-387-7117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300203341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590012683OtherRAILROAD MEDICARE
TX000704901Medicaid
590012683OtherRAILROAD MEDICARE