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General NPI Number Information
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NPI Number | 1912056730
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Entity Type | Organization
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Legal Business Name | BRAZOS VALLEY COMMUNITY ACTION AGENCY INC
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3400 S TEXAS AVE BLDG. A SUITE 300
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City | BRYAN
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State | TX
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Zip | 77802-3148
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Country | US
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Telephone | 979-595-1755
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Fax | 979-810-8151
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Provider Business Mailing Address
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Address Line | 3400 S TEXAS AVE BLDG A SUITE 300
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City | BRYAN
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State | TX
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Zip | 77802-3148
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Country | US
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Telephone | 979-977-6384
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | THERESA SABELLA
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Credential |
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Telephone | 979-383-2348
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 16909
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License Number State | TX
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