1548475643 NPI number — VALLEY BAPTIST MEDICAL CENTER

Table of content: (NPI 1548475643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548475643 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:
1548475643
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. DRAWER 2588
Provider Second Line Business Mailing Address:
4405 GLASSCOCK AVE
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:
956-389-2450
Provider Business Mailing Address Fax Number:
956-389-2434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4405 GLASSCOCK AVE
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:
78550-9209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-389-2450
Provider Business Practice Location Address Fax Number:
956-389-2434
Provider Enumeration Date:
05/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GRAYSON
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
ERIC
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
956-389-2451

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X , with the licence number:  16640 , 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: 250402 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 750457 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com