Provider Demographics
NPI:1619270188
Name:VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE
Entity Type:Organization
Organization Name:VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VICE PRESIDENT AND CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-698-5800
Mailing Address - Street 1:1040 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-6338
Mailing Address - Country:US
Mailing Address - Phone:956-698-5400
Mailing Address - Fax:956-698-5583
Practice Address - Street 1:1040 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-6338
Practice Address - Country:US
Practice Address - Phone:956-698-5400
Practice Address - Fax:956-698-5583
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY BAPTIST HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000314282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1652414-05Medicaid