1821185299 NPI number — BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.

Table of content: (NPI 1821185299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821185299 NPI number — BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRAZOS VALLEY COMMUNITY ACTION AGENCY, 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:
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:
1821185299
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 UNIVERSITY DR E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLLEGE STATION
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77840-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-810-8148
Provider Business Mailing Address Fax Number:
979-260-9390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 UNIVERSITY DR E
Provider Second Line Business Practice Location Address:
#100
Provider Business Practice Location Address City Name:
COLLEGE STATION
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77840-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-846-1100
Provider Business Practice Location Address Fax Number:
979-260-9390
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KIRKLAND
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CREDENTIALING
Authorized Official Telephone Number:
979-596-5852

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)

  • Identifier: 1568519122 . This is a "NPI L" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1700973187 . This is a "NPI G" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 187842302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000951607 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1750470084 . This is a "NPI M" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1912056730 . This is a "NPI PHARM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1275726853 . This is a "NPI CS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 187842301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 21721320 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1275620551 . This is a "NPI ROBERTSON CHC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 154467801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 154467803 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649265646 . This is a "NPI BCS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1407163660 . This is a "ROCK PRAIRIE FAMILY MEDICINE AND OBSTETRICS-NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 185649401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000951608 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1043527476 . This is a "COLLEGE STATION FAMILY MEDICINE CLINIC - NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1811171580 . This is a "NPI MEDICAID GROUP OB BILLING" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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