Provider Demographics
NPI:1437208360
Name:BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
Entity Type:Organization
Organization Name:BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
Other - Org Name:LUCIO CAMPUS CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-548-7400
Mailing Address - Street 1:2137 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2908
Mailing Address - Country:US
Mailing Address - Phone:956-838-6604
Mailing Address - Fax:956-838-6108
Practice Address - Street 1:300 N VERMILLION AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-6873
Practice Address - Country:US
Practice Address - Phone:956-838-6604
Practice Address - Fax:956-838-6108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center