Prairie View a&M University

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

PRAIRIE VIEW A&M UNIVERSITY

Practice address

1125 Reda Bland & Oj Baker St
Prairie View, TX 77446

Phone

(936) 261-1410

Fax

(936) 261-1452

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Glenn E Berry, M.D.

Title

Medical Director

Phone

(936) 261-1410

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Owens-Franklin Health Center Other name

Practitioners 1

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

• Ruth Smith, RN, WHNP

  • Women's Health Nurse Practitioner
  • Prairie View, TX
  • NPI 1063940369
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1639239874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 519 MS 1413",
            "city": "PRAIRIE VIEW",
            "state": "TX",
            "postal_code": "77446",
            "telephone_number": "936-261-1410",
            "fax_number": "936-261-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 REDA BLAND & OJ BAKER ST",
            "city": "PRAIRIE VIEW",
            "state": "TX",
            "postal_code": "77446",
            "telephone_number": "936-261-1410",
            "fax_number": "936-261-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE VIEW A&M UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "936-261-1410",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D1052515",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owens-Franklin Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Owens-Franklin Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maryellen Hole
• Labelle Health Care Services
• Davina Demetria Mitchell
• Cosmas Asonye Nwogwugwu
• Owens Franklin Health Center, Prairie View a&M University
• Ruth Smith, RN, WHNP
• Star of Texas Home Health LLC
• Waller-Harris Emergency Services
• Mokeitha Williams, LPC
• Sarah B Williams, LCSW

• Student Health Clinic/Center in Prairie View, TX
• Providers in Prairie View, TX by specialty
• Student Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.