Victoria of Texas LP

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

VICTORIA OF TEXAS LP

Practice address

101 Medical Dr
Victoria, TX 77904-3102

Phone

(361) 573-6100

Fax

(361) 788-2693

NPI assigned

Jun 20, 2007

Organization subpart

No

Name

Debbie Brewer

Title

Director of Provider Enrollment

Phone

(877) 892-9813

• DeTar Hospital North Emergency Department Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 30, 2011.

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1740485697",
    "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": "101 MEDICAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043102",
            "telephone_number": "361-573-6100",
            "fax_number": "361-788-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA OF TEXAS LP",
        "organizational_subpart": "NO",
        "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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143687502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00401R",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143687501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeTar Hospital North Emergency Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria of Texas LP
• Victoria of Texas LP
• Victoria of Texas LP
• Victoria of Texas LP
• Victoria of Texas LP
• Victoria of Texas LP
• Victoria of Texas LP
• Victoria Oral & Maxillofacial Surgery Associates Inc,
• Victoria Orthodontic Associates
• Victoria Orthopedic & Sports Medicine Clinic

• All providers in Victoria, TX
• Emergency Medicine Physician in Texas

• 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.