1609866003 NPI number — VALLEY RADIOLOGISTS & ASSOCIATES

Table of content: DR. BRITTANY ALEXA KOPEC DC (NPI 1639778855)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609866003 NPI number — VALLEY RADIOLOGISTS & ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY RADIOLOGISTS & ASSOCIATES
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:
1609866003
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2109
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN BENITO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78586-0055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-287-3198
Provider Business Mailing Address Fax Number:
614-764-9147

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1717 TREASURE HILLS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-8912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-421-3041
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FISHER
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
956-421-3041

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 082282701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022925401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 017073200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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