Provider Demographics
NPI:1902857543
Name:VICTORIA COUNTY
Entity Type:Organization
Organization Name:VICTORIA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR OF HEALTH DEPART
Authorized Official - Prefix:MS
Authorized Official - First Name:DELILAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:361-578-6281
Mailing Address - Street 1:2805 N NAVARRO ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3946
Mailing Address - Country:US
Mailing Address - Phone:361-578-6281
Mailing Address - Fax:361-485-9062
Practice Address - Street 1:2805 N NAVARRO ST
Practice Address - Street 2:SUITE 102
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3946
Practice Address - Country:US
Practice Address - Phone:361-578-6281
Practice Address - Fax:361-485-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1209793-02Medicaid
TXPH0015Medicare ID - Type Unspecified