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General NPI Number Information
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NPI Number | 1740266444
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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 | 12/15/2005
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2137 E 22ND ST
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2908
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Country | US
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Telephone | 956-548-7400
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Fax | 956-546-2056
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Provider Business Mailing Address
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Address Line | 2137 E 22ND ST
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2908
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Country | US
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Telephone | 956-548-7400
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Fax | 956-546-2056
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Authorized Official
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Title or Position | CEO
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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