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General NPI Number Information
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NPI Number | 1295778512
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Entity Type | Organization
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Legal Business Name | BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 191 E PRICE RD
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3527
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Country | US
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Telephone | 956-621-3645
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Fax | 956-544-1662
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Provider Business Mailing Address
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Address Line | 191 E PRICE RD
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3527
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Country | US
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Telephone | 956-548-7431
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Fax | 956-544-1662
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JASON K WALLACE
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Credential |
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Telephone | 956-548-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1292
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License Number State | TX
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