Provider Demographics
NPI:1992866164
Name:BROWNSVILLE PULMONARY CENTER, P.A.
Entity Type:Organization
Organization Name:BROWNSVILLE PULMONARY CENTER, P.A.
Other - Org Name:SOUTH TEXAS DURABLE MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-542-9900
Mailing Address - Street 1:844 CENTRAL BLVD.
Mailing Address - Street 2:STE. 420
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-542-9900
Mailing Address - Fax:956-574-0003
Practice Address - Street 1:844 CENTRAL BLVD
Practice Address - Street 2:STE. 420
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7552
Practice Address - Country:US
Practice Address - Phone:956-542-9900
Practice Address - Fax:956-574-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161983502Medicaid
TX161983502Medicaid
TX161983503Medicaid