Basic Information
| Provider Information | |||||||||
| NPI: | 1952512469 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE | ||||||||
| LastName: | |||||||||
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| MiddleName: | |||||||||
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| OtherOrganizationName: | VALLEY BAPTIST MEDICAL FACILITY BROWNSVILLE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1040 W JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785206338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566985400 | ||||||||
| FaxNumber: | 9566985747 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 TED HUNT BLVD | ||||||||
| Address2: | |||||||||
| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785217801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566985400 | ||||||||
| FaxNumber: | 9566985747 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 10/02/2007 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BINGHAM | ||||||||
| AuthorizedOfficialFirstName: | LESLIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SR. VICE PRESIDENT AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 9566985457 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | VALLEY BAPTIST HEALTH SYSTEM | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 000314 | TX | Y | Hospital Units | Psychiatric Unit |
No ID Information.