1134298466 NPI number — RIO GRANDE VALLEY HOSPITAL SERVICES

Table of content: (NPI 1134298466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134298466 NPI number — RIO GRANDE VALLEY HOSPITAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIO GRANDE VALLEY HOSPITAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134298466
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7500 RIALTO BLVD STE 140
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78735-8531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-440-6300
Provider Business Mailing Address Fax Number:
888-698-3908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
512 VICTORIA LN
Provider Second Line Business Practice Location Address:
STE 12
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-3226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-440-6322
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COURTNEY
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
B
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
512-730-3053

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: TXL926 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: TXL926 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0020QU . This is a "BCTX GROUP#" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00X144 . This is a "GROUP MEDICARE#" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 192222101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8AU020 . This is a "BCTX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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