Provider Demographics
NPI:1255414744
Name:ST. JOSEPH REGIONAL HEALTH CENTER
Entity type:Organization
Organization Name:ST. JOSEPH REGIONAL HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT FINANCIAL SERVICES MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-776-2426
Mailing Address - Street 1:2800 S TEXAS AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-5361
Mailing Address - Country:US
Mailing Address - Phone:362-663-5139
Mailing Address - Fax:936-266-8618
Practice Address - Street 1:102 WEST MAIN ST.
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TX
Practice Address - Zip Code:75833
Practice Address - Country:US
Practice Address - Phone:903-536-2313
Practice Address - Fax:903-536-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR04534439Medicaid
TX453443Medicare PIN