Provider Demographics
NPI:1760573000
Name:PLANNED PARENTHOOD ASSOCIATION OF CAMERON AND WILLACY COUNTIES
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD ASSOCIATION OF CAMERON AND WILLACY COUNTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-453-1799
Mailing Address - Street 1:104 BABCOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3806
Mailing Address - Country:US
Mailing Address - Phone:210-736-2244
Mailing Address - Fax:210-736-0011
Practice Address - Street 1:1028 S 14TH ST
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-6422
Practice Address - Country:US
Practice Address - Phone:361-592-2649
Practice Address - Fax:361-595-4618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137339103Medicaid