Provider Demographics
NPI:1982705604
Name:VALLEY BAPTIST MEDICAL CENTER
Entity Type:Organization
Organization Name:VALLEY BAPTIST MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VICE PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WESSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-389-1672
Mailing Address - Street 1:PO BOX 2588
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78551-2588
Mailing Address - Country:US
Mailing Address - Phone:956-389-1268
Mailing Address - Fax:956-389-4536
Practice Address - Street 1:4405 GLASSCOCK AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-9209
Practice Address - Country:US
Practice Address - Phone:956-389-2450
Practice Address - Fax:956-389-2434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16640251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1002600001Medicare ID - Type Unspecified