1245508407 NPI number — RGV ELDER HEALTH SYSTEMS, INC

Table of content: (NPI 1245508407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245508407 NPI number — RGV ELDER HEALTH SYSTEMS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RGV ELDER HEALTH SYSTEMS, INC
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:
1245508407
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1893
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSION
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78573-0031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-583-8013
Provider Business Mailing Address Fax Number:
956-583-5120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 HWY 107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MISSION
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78573-8247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-583-8013
Provider Business Practice Location Address Fax Number:
956-583-5120
Provider Enumeration Date:
12/02/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MADRIGALES
Authorized Official First Name:
BENJAMIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
956-533-6825

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  131994 , 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: 001012462 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1548477748 . This is a "NPI NUMBER FOR ANOTHER D/B/A BEST HEALTH SERVICES" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001015269 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".