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NPI Code Detail

MEDICARE: BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION

MEDICARE: BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0002XClinic Pharmacy
33336C0003XCommunity/Retail Pharmacy1292TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12093720OTHERPK

General Provider Information

NPI Number : 1295778512
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
Provider Business Mailing Address
First Line : 191 E PRICE RD
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78521-3527
Country : US
Telephone Number : 956-548-7431
Fax Number : 956-544-1662
Provider Business Practice Location Address
First Line : 191 E PRICE RD
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78521-3527
Country : US
Telephone Number : 956-621-3645
Fax Number : 956-544-1662
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : JASON K WALLACE
Credential :
Telephone Number : 956-548-7400
Provider Enumeration Date : 06/14/2006
Last Update Date : 01/07/2025

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Practice Fax: 956-621-3689
1972560423 — DR. BRADLEY WILLIAM NORDYKE M.D.
Practice Location Address:
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1679595847 — ANDREA WATSON M.D.
Practice Location Address:
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1134142854 — DR. JULIA JUANITA DELGADO M.D.
Practice Location Address:
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78521-3527
Practice Phone: 956-548-7400
Practice Fax: 956-621-3689

Directions to “BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION ” Practice Location

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