Provider Demographics
NPI:1255483178
Name:BROWNSVILLE OBSTETRICS AND GYNECOLOGY ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:BROWNSVILLE OBSTETRICS AND GYNECOLOGY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:CMM, CMPE
Authorized Official - Phone:956-550-8733
Mailing Address - Street 1:800 W JEFFERSON ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-6329
Mailing Address - Country:US
Mailing Address - Phone:956-550-8733
Mailing Address - Fax:956-550-9299
Practice Address - Street 1:800 W JEFFERSON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-6329
Practice Address - Country:US
Practice Address - Phone:956-550-8733
Practice Address - Fax:956-550-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085787201Medicaid
TX085787201Medicaid