Provider Demographics
NPI:1780768911
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:979-776-2426
Mailing Address - Fax:979-776-5948
Practice Address - Street 1:305 W GAY ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TX
Practice Address - Zip Code:77856-4871
Practice Address - Country:US
Practice Address - Phone:979-776-2426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
092087801OtherEPSDT
TX092087802Medicaid
TX092087802Medicaid