Provider Demographics
NPI:1861488579
Name:KNAPP MEDICAL CENTER
Entity Type:Organization
Organization Name:KNAPP MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SURROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-323-9106
Mailing Address - Street 1:1401 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6640
Mailing Address - Country:US
Mailing Address - Phone:956-968-8567
Mailing Address - Fax:956-969-1408
Practice Address - Street 1:1401 E 8TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6640
Practice Address - Country:US
Practice Address - Phone:956-968-8567
Practice Address - Fax:956-969-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
TX000480282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104307100OtherVALLEY HEALTH PLANS
TXHH0538OtherBC BS OF TEXAS
TX135035705Medicaid
TX135035706Medicaid
TX450128B000000Medicare ID - Type UnspecifiedSECTION 1011 PROGRAM
TX135035705Medicaid
TXHH0538OtherBC BS OF TEXAS