Provider Demographics
NPI:1083664759
Name:BROWNSVILLE PULMONARY CENTER, P.A.
Entity Type:Organization
Organization Name:BROWNSVILLE PULMONARY CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-542-9900
Mailing Address - Street 1:844 CENTRAL BLVD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7552
Mailing Address - Country:US
Mailing Address - Phone:956-542-9900
Mailing Address - Fax:956-574-0003
Practice Address - Street 1:844 CENTRAL BLVD
Practice Address - Street 2:SUITE 420
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7552
Practice Address - Country:US
Practice Address - Phone:956-428-7862
Practice Address - Fax:956-440-0395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161983503Medicaid
TX161983504Medicaid
TX161983502Medicaid
TX0060GHOtherBLUE CROSS BLUE SHIELD
TX161983501Medicaid
TX161983503Medicaid