1346567948 NPI number — VSHSI LPISD COMMUNITY BASED AND SCHOOL BASED CLINIC

Table of content: (NPI 1366610388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346567948 NPI number — VSHSI LPISD COMMUNITY BASED AND SCHOOL BASED CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VSHSI LPISD COMMUNITY BASED AND SCHOOL BASED CLINIC
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:
1346567948
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
308 S. CESAR CHAVEZ AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CRYSTAL CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-374-2301
Provider Business Mailing Address Fax Number:
830-374-9368

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
117 E. HWY 57
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA PRYOR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78872
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-365-4528
Provider Business Practice Location Address Fax Number:
830-365-4023
Provider Enumeration Date:
04/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
TELLEZ
Authorized Official First Name:
NORA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
830-374-2301

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com