MEDICARE: BROWNSVILLE CARE CENTER PA

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
1	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1336195395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWNSVILLE CARE CENTER PA

Provider Business Mailing Address
First Line	:	864 CENTRAL BLVD
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-7551
Country	:	US
Telephone Number	:	956-546-0225
Fax Number	:	956-546-0744

Provider Business Practice Location Address
First Line	:	864 CENTRAL BLVD
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-7551
Country	:	US
Telephone Number	:	956-546-0225
Fax Number	:	956-546-0744

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDUARDO A KOFMAN
Credential	:	MD
Telephone Number	:	956-546-0225

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	06/30/2008

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