1679626576 NPI number — SOUTH TEXAS FAMILY PLANNING & HEALTH CORPORATION

Table of content: (NPI 1679626576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679626576 NPI number — SOUTH TEXAS FAMILY PLANNING & HEALTH CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH TEXAS FAMILY PLANNING & HEALTH CORPORATION
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:
1679626576
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4455 S PADRE ISLAND DR
Provider Second Line Business Mailing Address:
SUITE #29
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78411-5101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-855-7333
Provider Business Mailing Address Fax Number:
361-851-2067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 PAT SHUTTER ST
Provider Second Line Business Practice Location Address:
UNIT #121
Provider Business Practice Location Address City Name:
ROBSTOWN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78380-3448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-387-6996
Provider Business Practice Location Address Fax Number:
361-387-6996
Provider Enumeration Date:
01/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZUNIGA
Authorized Official First Name:
MARTHA
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
361-855-7333

Provider Taxonomy Codes

  • Taxonomy code: 261QA0005X , with the licence number:  45D0716424 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X , with the licence number: 45D0716424 , 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: 088329004 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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