Provider Demographics
NPI:1790858769
Name:CITY OF LAREDO
Entity Type:Organization
Organization Name:CITY OF LAREDO
Other - Org Name:CITY OF LAREDO HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH,MPH,CPHA,CPM,
Authorized Official - Phone:956-795-4900
Mailing Address - Street 1:2600 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-4040
Mailing Address - Country:US
Mailing Address - Phone:956-795-4900
Mailing Address - Fax:956-726-2632
Practice Address - Street 1:2600 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-2337
Practice Address - Country:US
Practice Address - Phone:956-795-4900
Practice Address - Fax:956-726-2632
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF LAREDO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-16
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251K00000X
261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137917407Medicaid
TX172607701Medicaid
TX137917412Medicaid
TX119881402Medicaid
TX137917401Medicaid
TX137917409Medicaid
TX172606901Medicaid
TX137917402Medicaid
TX137917405Medicaid
TX137917403Medicaid
TX137917410Medicaid
TX137917406Medicaid
TX137917408Medicaid
TXB27271Medicare UPIN
TX00F18YMedicare ID - Type UnspecifiedLA FAMILIA
TX137917405Medicaid
TX137917403Medicaid
TX137917402Medicaid
TX172607701Medicaid