Provider Demographics
NPI:1730370735
Name:A SMART CHOICE EMERGENCY MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:A SMART CHOICE EMERGENCY MEDICAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BERKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-694-6911
Mailing Address - Street 1:PO BOX 112028
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77293-2028
Mailing Address - Country:US
Mailing Address - Phone:713-694-6911
Mailing Address - Fax:
Practice Address - Street 1:7900 1/2 EASTEX FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-8403
Practice Address - Country:US
Practice Address - Phone:713-694-6911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000037341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000037OtherLICENSE NUMBER
TXAMB630Medicare PIN