1144397316 NPI number — ST. JOSEPH REGIONAL HEALTH CENTER

Table of content: (NPI 1144397316)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144397316 NPI number — ST. JOSEPH REGIONAL HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. JOSEPH REGIONAL 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:
1144397316
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2800 S TEXAS AVE STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRYAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77802-5361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
936-266-3513
Provider Business Mailing Address Fax Number:
936-266-8618

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8465 N. HWY. 77
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78947-0577
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-773-9000
Provider Business Practice Location Address Fax Number:
979-773-9501
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
TERESA
Authorized Official Middle Name:
Authorized Official Title or Position:
PATIENT FINANCIAL SERVICES MANAGER
Authorized Official Telephone Number:
979-776-2426

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , with the licence number:  000679 , 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: 063621901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com