Provider Demographics
NPI:1538347026
Name:CITY OF CELINA
Entity type:Organization
Organization Name:CITY OF CELINA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIVISION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-742-9451
Mailing Address - Street 1:PO BOX 498848
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75049-8848
Mailing Address - Country:US
Mailing Address - Phone:214-340-2650
Mailing Address - Fax:214-503-7135
Practice Address - Street 1:1413 S PRESTON RD
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-3765
Practice Address - Country:US
Practice Address - Phone:972-525-0748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10000983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1538347026Medicaid
TX1000098OtherDSHS