Basic Information
| Provider Information | |||||||||
| NPI: | 1982774733 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARLINGEN HOSPITALIST GROUP PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7500 RIALTO BLVD STE 140 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787358531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564406300 | ||||||||
| FaxNumber: | 8886983908 | ||||||||
| Practice Location | |||||||||
| Address1: | 5501 S EXPRESSWAY 77 | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564406322 | ||||||||
| FaxNumber: | 9564406382 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 07/20/2015 | ||||||||
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| AuthorizedOfficialLastName: | COURTNEY | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5127303053 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HNI MEDICAL SERVICES | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | TXL926 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | TXL926 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 0069KV | 01 | TX | BC/BS | OTHER | 162782002 | 05 | TX | MEDICAID |