Organization Active NPI

Victoria of Texas LP

Doing business as DeTar Senior Care Center

  • Emergency Medicine Physician
  • Victoria, TX
National Provider Identifier
1619172467
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
VICTORIA OF TEXAS LP
Doing business as
DeTar Senior Care Center
Practice address
605 E San Antonio St
Suite 310E
Victoria, TX 77901-6040
Phone
(361) 575-0228
Fax
(361) 575-0782
NPI assigned
Jun 20, 2007
Last updated
Jun 30, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
VICTORIA OF TEXAS LPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Authorized official

Name
Debbie Brewer
Title
Director of Provider Enrollment
Phone
(877) 892-9813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

605 E San Antonio St
Suite 310E
Victoria, TX 77901-6040

Mailing address

PO Box 689022
Franklin, TN 37068-9022

Other names 1

  • DeTar Senior Care Center Doing business as

National Provider Directory

National Provider Directory
Part of
Robert Simpkins MD

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1619172467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E SAN ANTONIO ST",
            "address_2": "SUITE 310E",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779016040",
            "telephone_number": "361-575-0228",
            "fax_number": "361-575-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA OF TEXAS LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VICTORIA OF TEXAS LP",
        "enumeration_date": "2007-06-20",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeTar Senior Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.