Healthcare Provider Details

I. General information

NPI: 1245421783
Provider Name (Legal Business Name): BROWNSVILLE COMMUNITY HEALTH CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 CHAMPION AVE
PORT ISABEL TX
78578-2908
US

IV. Provider business mailing address

2137 E 22ND ST
BROWNSVILLE TX
78521-2908
US

V. Phone/Fax

Practice location:
  • Phone: 956-943-1300
  • Fax:
Mailing address:
  • Phone: 956-548-7400
  • Fax: 956-546-2056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: PAULA S. GOMEZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 956-548-7440