1760582795 NPI number — VALLEY BAPTIST MEDICAL CENTER

Table of content: (NPI 1760582795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760582795 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:
VALLEY BAPTIST DIALYSIS CENTER
Provider Other Organization Name Type Code:
3
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:
1760582795
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 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:
956-389-1268
Provider Business Mailing Address Fax Number:
956-389-4536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2220 HAINE DR STE 40
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:
78550-8584
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-389-2372
Provider Business Practice Location Address Fax Number:
956-389-2391
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WESSON
Authorized Official First Name:
JIM
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: 261QE0700X , with the licence number:  000104 , 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)





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