Provider Demographics
NPI:1922147206
Name:TOWN OF PROSPER
Entity type:Organization
Organization Name:TOWN OF PROSPER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:BLASINGAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-347-2424
Mailing Address - Street 1:PO BOX 495548
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75049-5548
Mailing Address - Country:US
Mailing Address - Phone:214-340-2650
Mailing Address - Fax:214-503-7135
Practice Address - Street 1:1500 E 1ST ST
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-8971
Practice Address - Country:US
Practice Address - Phone:729-347-2424
Practice Address - Fax:800-353-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0430123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX590015586OtherRAILROAD MEDICARE
TX1922147206Medicaid
TXAMB643OtherBLUE CROSS BLUE SHIELD
TXAMB271Medicare PIN