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General NPI Number Information
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NPI Number | 1699078444
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Entity Type | Organization
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Legal Business Name | TEXAS PHC CORPORATION
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 1175 N MEDFORD RD
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City | BROWNSVILLE
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State | TX
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Zip | 78521-8402
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Country | US
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Telephone | 956-372-7074
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Fax |
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Provider Business Mailing Address
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Address Line | 1171 N FRONTAGE STE B
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2095
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Country | US
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Telephone | 956-372-7074
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Fax |
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Authorized Official
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Title or Position | ADMINSTRATOT
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Name | MRS. NERISSA V MORALES
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Credential |
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Telephone | 956-372-7074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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