NPIMap

Organization Active NPI

Federal Prison Camp

  • Prison Health Clinic/Center
  • Bryan, TX
National Provider Identifier
1992061188
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
FEDERAL PRISON CAMP
Practice address
1100 Ursuline Ave
Bryan, TX 77803-4951
Phone
(979) 823-1879
Fax
(979) 821-3315
NPI assigned
Apr 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Ms. Kathleen L Rivers, RN
Title
Health Services Administrator
Phone
(979) 823-1879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary

Addresses

Primary practice location

1100 Ursuline Ave
Bryan, TX 77803-4951

Mailing address

1100 Ursuline Ave
Bryan, TX 77805-2197
Phone (979) 823-1879

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0707642Federal Prison Camp Bryan1100 Ursuline, Bryan, TX 77803Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Fci Texarkana49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

Locations

1100 Ursuline Ave
Bryan, TX 77803
Phone (979) 823-1879

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1992061188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 URSULINE AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778052197",
            "telephone_number": "979-823-1879",
            "fax_number": "979-821-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 URSULINE AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778034951",
            "telephone_number": "979-823-1879",
            "fax_number": "979-821-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERAL PRISON CAMP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "HEALTH SERVICES ADMINISTRATOR",
        "authorized_official_telephone_number": "979-823-1879",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.