1629034871 NPI number — ROSIE C. BELANDRES-HICBAN,M.D.,P.A

Table of content: (NPI 1629034871)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629034871 NPI number — ROSIE C. BELANDRES-HICBAN,M.D.,P.A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROSIE C. BELANDRES-HICBAN,M.D.,P.A
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:
CHILDREN'S HEALTHCARE CENTER
Provider Other Organization Name Type Code:
5
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:
1629034871
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1999
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDINBURG
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78540-1999
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3145 W ALBERTA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78539-9402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-682-6872
Provider Business Practice Location Address Fax Number:
956-630-4843
Provider Enumeration Date:
04/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BELANDRES-HICBAN
Authorized Official First Name:
ROSIE
Authorized Official Middle Name:
CADIZ
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
956-682-6872

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0019KP . This is a "BCBS GRP #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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