1508386921 NPI number — BELLVILLE MEDICAL CENTER

Table of content: DR. SUPRAJA NILA PARTHASARATHY M.D. (NPI 1386962710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508386921 NPI number — BELLVILLE MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELLVILLE 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:
6
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:
1508386921
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
305 SANDY CORNER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL CAMPO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77437-9535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-543-5510
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 W PALM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77418-1372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-413-7300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2017

Additional Information

Authorized Official

Authorized Official Last Name:
KIRKHAM
Authorized Official First Name:
BRETT
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
979-543-6251

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 673494 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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