1518985944 NPI number — SOUTH TEXAS HEALTH CENTERS, INC

Table of content: (NPI 1518985944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518985944 NPI number — SOUTH TEXAS HEALTH CENTERS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH TEXAS HEALTH CENTERS, 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:
SOUTH TEXAS CHIROPRACTIC
Provider Other Organization Name Type Code:
4
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:
1518985944
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6826 SPRINGFIELD AVE.
Provider Second Line Business Mailing Address:
#102
Provider Business Mailing Address City Name:
LAREDO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-726-9886
Provider Business Mailing Address Fax Number:
956-722-1590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6826 SPRINGFIELD AVE.
Provider Second Line Business Practice Location Address:
#102
Provider Business Practice Location Address City Name:
LAREDO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-722-9886
Provider Business Practice Location Address Fax Number:
956-722-1590
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FRYE
Authorized Official First Name:
KAYCE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
956-726-9886

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  5449 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1016277101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00189401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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