1316055833 NPI number — VALLEY BAPTIST MEDICAL CENTER

Table of content: (NPI 1316055833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316055833 NPI number — VALLEY BAPTIST MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY BAPTIST MEDICAL CENTER
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:
1316055833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO DRAWER 2588
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARLINGEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78551-2588
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-389-2060
Provider Business Mailing Address Fax Number:
956-389-2017

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2101 PEASE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-8307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-389-1672
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WESSON
Authorized Official First Name:
JIMMY
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
SR. VICE PRESIDENT & CEO
Authorized Official Telephone Number:
956-389-1672

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  000400 , 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: 0659336 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 09404235 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 95500336 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 450033B000000 . This is a "SECTION 1011 FEDERAL PROG" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 450033 . This is a "TWCC WORKERS COMP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 25216 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3150604 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0062 . This is a "BC-BS OF TX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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