NPIMap

Organization Active NPI

Provider Services of Texas LLC

  • Diagnostic Radiology Physician
  • Brownsville, TX
National Provider Identifier
1215260559
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PROVIDER SERVICES OF TEXAS LLC
Practice address
100A E Alton Gloor Blvd
Brownsville, TX 78526-3375
Phone
(956) 350-7000
Fax
(214) 712-2487
NPI assigned
Sep 17, 2009
Last updated
Jul 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William C Jernberg, MD
Title
President
Phone
(214) 712-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

100A E Alton Gloor Blvd
Brownsville, TX 78526-3375

Mailing address

13737 Noel Rd
Suite 1600
Dallas, TX 75240-1331
Phone (214) 712-2074

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1215260559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "address_2": "SUITE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "214-712-2074",
            "fax_number": "214-712-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100A E ALTON GLOOR BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785263375",
            "telephone_number": "956-350-7000",
            "fax_number": "214-712-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER SERVICES OF TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-17",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "JERNBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-712-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.