1851388649 NPI number — HARLINGEN BONE & JOINT CLINIC, P.A.

Table of content: (NPI 1851388649)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851388649 NPI number — HARLINGEN BONE & JOINT CLINIC, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARLINGEN BONE & JOINT CLINIC, P.A.
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:
1851388649
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1801 N ED CAREY DR
Provider Second Line Business Mailing Address:
STE. A
Provider Business Mailing Address City Name:
HARLINGEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78550-8268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-423-5033
Provider Business Mailing Address Fax Number:
956-412-3028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 N ED CAREY DR
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:
78550-8268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-423-5033
Provider Business Practice Location Address Fax Number:
956-412-3028
Provider Enumeration Date:
10/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KEILLOR
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
956-423-5033

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D6052 , 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: 091574601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00L35B . This is a "BCBS OF TX GRP PROV #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 129821100 . This is a "VALLEY HEALTH PLAN PROV #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 200005753 . This is a "RAILROAD MEDICARE PROV#" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 78550A002 . This is a "TRICARE PROV. #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 091574602 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com