1356313209 NPI number — DEVI WOMEN'S CENTER

Table of content: (NPI 1356313209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356313209 NPI number — DEVI WOMEN'S CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEVI WOMEN'S 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:
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:
1356313209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 532008
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:
78553-2008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-365-3655
Provider Business Mailing Address Fax Number:
956-365-3360

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1616 S CAROLINA ST
Provider Second Line Business Practice Location Address:
STE. A
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-8316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-365-3655
Provider Business Practice Location Address Fax Number:
956-365-3360
Provider Enumeration Date:
02/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SOSA
Authorized Official First Name:
ESTELA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
956-365-3655

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X , with the licence number:  H5492 , 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: 0048ER . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 101949100 . This is a "VALLEY HEALTH PLANS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 160053362 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 131247201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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