1295843753 NPI number — VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE

Table of content: (NPI 1295843753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295843753 NPI number — VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE
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:
1295843753
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1040 W JEFFERSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78520-6338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-698-5400
Provider Business Mailing Address Fax Number:
956-698-5583

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1040 W JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78520-6338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-544-1400
Provider Business Practice Location Address Fax Number:
956-541-0747
Provider Enumeration Date:
08/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BINGHAM
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. VICE PRESIDENT AND CEO
Authorized Official Telephone Number:
956-698-5800

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  000314 , 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: 450028 . This is a "TWCC WORKERS COMP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 102626101 . This is a "ALL VHP (VAM,VCC,TRS VHP)" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1652414-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165241401 . This is a "CHIP SUPERIOR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 450028B000000 . This is a "SECTION 1011 FED PROG" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 913179500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 99111423 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0017 . This is a "BC-BS OF TX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 602222000 . This is a "US DEPT LABOR WC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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