Provider Demographics
NPI:1144286683
Name:SOUTH TEXAS AMBULANCE RESPONSE, INC
Entity type:Organization
Organization Name:SOUTH TEXAS AMBULANCE RESPONSE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-800-1082
Mailing Address - Street 1:12285 PELLICANO DR STE A2
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6284
Mailing Address - Country:US
Mailing Address - Phone:915-800-1052
Mailing Address - Fax:
Practice Address - Street 1:12285 PELLICANO DR STE A2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6284
Practice Address - Country:US
Practice Address - Phone:915-800-1052
Practice Address - Fax:210-971-9468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-24
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
TX8000223416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175711401Medicaid
TXAMB441Medicare PIN