Provider Demographics
NPI:1053340737
Name:CITY OF DENISON
Entity type:Organization
Organization Name:CITY OF DENISON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MS
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-464-4427
Mailing Address - Street 1:700 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-3208
Mailing Address - Country:US
Mailing Address - Phone:903-465-2720
Mailing Address - Fax:903-465-3806
Practice Address - Street 1:700 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-3208
Practice Address - Country:US
Practice Address - Phone:903-464-4427
Practice Address - Fax:903-465-3806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX107777801Medicaid
OK100820550AMedicaid
TX826590027Medicare PIN
TX503371Medicare PIN