1598980526 NPI number — SOUTH TEXAS WOMEN'S & CHILDREN'S HEALTH CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598980526 NPI number — SOUTH TEXAS WOMEN'S & CHILDREN'S HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH TEXAS WOMEN'S & CHILDREN'S HEALTH 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:
1598980526
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 E SAVANNAH AVE
Provider Second Line Business Mailing Address:
SUITE 14
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78503-1728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-668-1200
Provider Business Mailing Address Fax Number:
956-668-1212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 E SAVANNAH AVE
Provider Second Line Business Practice Location Address:
SUITE 14
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78503-1727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-668-1200
Provider Business Practice Location Address Fax Number:
956-668-1212
Provider Enumeration Date:
04/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PEREZ
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
MARTIN
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
956-668-1200

Provider Taxonomy Codes

  • Taxonomy code: 207VX0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 151311101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 151311102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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