Provider Demographics
NPI:1649291550
Name:BROWNSVILLE WOMEN'S CLINIC LLP
Entity type:Organization
Organization Name:BROWNSVILLE WOMEN'S CLINIC LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:EMETTE
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-504-5701
Mailing Address - Street 1:844 CENTRAL BLVD
Mailing Address - Street 2:SUITE 380
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7552
Mailing Address - Country:US
Mailing Address - Phone:956-504-5701
Mailing Address - Fax:956-504-6910
Practice Address - Street 1:844 CENTRAL BLVD
Practice Address - Street 2:SUITE 380
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7552
Practice Address - Country:US
Practice Address - Phone:956-504-5701
Practice Address - Fax:956-504-6910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8750174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC19701Medicare UPIN