Outcomes Detox Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

OUTCOMES DETOX CENTER, LLC

Practice address

425 E Los Ebanos Blvd
Suites 101 and 108 - 109
Brownsville, TX 78520

Phone

(956) 546-3116

NPI assigned

Dec 31, 2015

Organization subpart

No

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

Authorized official

Name

Chris A. Tryka

Title

Ar Director

Phone

(956) 546-3116

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge R Guevara, MD

  • Internal Medicine Physician
  • Brownsville, TX
  • NPI 1629040654
  Medicare reassignment NPD

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1629433917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E LOS EBANOS BLVD",
            "address_2": "SUITES 108 - 109",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E LOS EBANOS BLVD",
            "address_2": "SUITES 101 AND 108 - 109",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "78520",
            "telephone_number": "956-546-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTCOMES DETOX CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-31",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "TRYKA",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "AR DIRECTOR",
        "authorized_official_telephone_number": "956-546-3116"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381185301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne Ortiz, SLPA
• Kevin Paul Osborne, DMD
• Kevin P Osmers, PHARMD
• Oryana Otero
• Rafael Otero
• Outpatient Hospital Services, LLC
• Ricardo Alberto Pacheco Torres, M.D.
• Clay Harold Padginton, DO
• Diana M Padilla
• Sabrinalee Padilla

• Substance Abuse Rehabilitation Facility in Brownsville, TX
• Providers in Brownsville, TX by specialty
• Substance Abuse Rehabilitation Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.