Provider Demographics
NPI:1932258241
Name:BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
Entity Type:Organization
Organization Name:BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
Other - Org Name:BROWNSVILLE COMMUNITY HEALTH CENTER AT CAMERON PARK
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-548-7400
Mailing Address - Street 1:2609 DELIA AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3696
Mailing Address - Country:US
Mailing Address - Phone:956-546-4243
Mailing Address - Fax:956-546-4163
Practice Address - Street 1:2609 DELIA AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3696
Practice Address - Country:US
Practice Address - Phone:956-546-4243
Practice Address - Fax:956-546-4163
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROWNSVILLE COMMUNITY HEALTH CLINIC CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX451969Medicare Oscar/Certification