Provider Demographics
NPI:1356665574
Name:CENTER FOR MEDICAL GENETICS OF BROWNSVILLE PLLC
Entity Type:Organization
Organization Name:CENTER FOR MEDICAL GENETICS OF BROWNSVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:H
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-790-1990
Mailing Address - Street 1:7400 FANNIN ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:713-790-1990
Mailing Address - Fax:713-790-1903
Practice Address - Street 1:302 LORENALY DR
Practice Address - Street 2:SUITE G
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4331
Practice Address - Country:US
Practice Address - Phone:713-790-1990
Practice Address - Fax:713-790-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1699207SC0300X, 207SG0201X, 2085U0001X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Multi-Specialty
No207SC0300XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical CytogeneticsGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020788802Medicaid
TX020788801Medicaid
TX058886503Medicaid
TX058886501Medicaid
TX058886501Medicaid