NPIMap

Organization Active NPI

Victoria of Texas LP

Doing business as DeTar Hospital North Emergency Department

  • Emergency Medicine Physician
  • Victoria, TX
National Provider Identifier
1740485697
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 Hospital North Emergency Department
Practice address
101 Medical Dr
Victoria, TX 77904-3102
Phone
(361) 573-6100
Fax
(361) 788-2693
NPI assigned
Jun 20, 2007
Last updated
Jun 30, 2011By the provider in NPPES
Organization subpart
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

101 Medical Dr
Victoria, TX 77904-3102

Mailing address

PO Box 689022
Franklin, TN 37068-9022

Other names 1

  • DeTar Hospital North Emergency Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740485697. Details of each certification follow.

Hospital certification: CCN 450724

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DETAR HOSPITAL NORTH
Certification status
Terminated Voluntary: merger or closure, Oct 1, 2000
Provider type (POS)
Hospital – Short-term
Participating since
Apr 3, 1984
Last certification
Jun 15, 2000
Beds
156 (147 certified)
Ownership / control type
Private (for profit)
Most recent change of ownership
Oct 1, 2000 (2 total)
Facility address
101 Medical Drive
Victoria, TX 77904

National Provider Directory

National Provider Directory

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": "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeTar Hospital North Emergency Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.