VICTORIA OF TEXAS LP (NPI# 1619172467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619172467 |
| Entity Type | Organization |
| Organization Name | VICTORIA OF TEXAS LP |
| Other Organization Name | DETAR SENIOR CARE CENTER |
| Practice Address |
605 E San Antonio St Suite 310e Victoria TX 77901-6040 |
| Mailing Address |
Po Box 689022 Franklin TN 37068-9022 |
| Practice Telephone | 3615750228 |
| Practice Fax Number | 3615750782 |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2011-06-30 |
| Authorized Official Name | DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 8778929813 |
| Is Organization Subpart | Y |
| Parent Organization Name | VICTORIA OF TEXAS LP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 093825001 | 05 | |
| BLUE CROSS | 00GT06 | 01 |
| Other Name | Type Code |
|---|---|
| DeTar Senior Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851343909 | Victoria of Texas Lp | Clinic/Center | 506 E San Antonio St, Victoria, TX 77901-6060 | 2006-05-17 |
| 1578180725 | Victoria of Texas Lp | Medicare Defined Swing Bed Unit | 506 E San Antonio St, Victoria, TX 77901-6060 | 2020-07-02 |
| 1427338508 | Victoria of Texas Lp | Psychiatric Unit | 101 Medical Dr, Victoria, TX 77904-3102 | 2011-08-22 |
| 1003141128 | Victoria of Texas Lp | General Acute Care Hospital | 506 E San Antonio St, Victoria, TX 77901-6060 | 2009-10-07 |
| 1952636060 | Victoria of Texas Lp | Clinic/Center | 506 E San Antonio St, Victoria, TX 77901-6060 | 2009-10-07 |
| 1740485697 | Victoria of Texas Lp | Emergency Medicine | 101 Medical Dr, Victoria, TX 77904-3102 | 2007-06-20 |
| 1558453902 | Victoria of Texas Lp | Dietitian, Registered | 506 E San Antonio St, Victoria, TX 77901-6060 | 2006-09-29 |
| 1265487706 | Victoria of Texas Lp | Skilled Nursing Facility | 605 E San Antonio St, Victoria, TX 77901-6050 | 2006-05-23 |
| 1053366625 | Victoria of Texas Lp | Rehabilitation Unit | 506 E San Antonio St, Victoria, TX 77901-6060 | 2006-05-23 |
| Street Address |
605 E SAN ANTONIO ST SUITE 310E |
| City | VICTORIA |
| State | TX |
| Zip Code | 77901-6040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295738730 | Leon Ira Gilner | Neurological Surgery | 605 E San Antonio St, Suite 510e, Victoria, TX 77901-6050 | 2005-05-28 |
| 1588038152 | Michael Dillon Hannasch | Physician Assistant | 605 E San Antonio St, Ste 520e, Victoria, TX 77901-6050 | 2015-11-19 |
| 1902245442 | Laurie Lynn Srubar | Nurse Practitioner | 605 E San Antonio St, Suite 310e, Victoria, TX 77901-6050 | 2013-06-18 |
| 1831537067 | Donald W. Breech, Md, Pa | Orthopaedic Surgery | 605 E San Antonio St, Suite 410e, Victoria, TX 77901-6050 | 2013-06-10 |
| 1124306782 | Rima Diane Garrett | Nurse Practitioner | 605 E San Antonio St, Suite 508e, Victoria, TX 77901-6050 | 2011-08-01 |
| 1043598535 | Kyra Diane Smith | Nurse Practitioner | 605 E San Antonio St, Suite 508e, Victoria, TX 77901-6050 | 2011-08-01 |
| 1952633927 | Paul E Mondolfi, Md, Pa | Plastic Surgery | 605 E San Antonio St, Suite 450 E, Victoria, TX 77901-6040 | 2010-02-02 |
| 1326225848 | Donald W Breech Md Pa | Orthopaedic Surgery | 605 E San Antonio St, Ste 410 E, Victoria, TX 77901-6040 | 2008-01-28 |
| 1720263379 | Donald W. Breech Md Pa | Orthopaedic Surgery | 605 E San Antonio St, Suite 410 E, Victoria, TX 77901-6061 | 2008-01-02 |
| 1881745750 | Lissette Alvarado I | Family Medicine | 605 E San Antonio St, Suite 414 E, Victoria, TX 77901-6040 | 2007-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962540 | Uc Management Group LLC | Nurse Practitioner | 1908 N Laurent St Ste 410, Victoria, TX 77901 | 2020-08-12 |
| 1558823336 | Uzoma Melissa Obi-nwankwo | Family Medicine | Detar Family Medicine Center, 501 E Colorado St., Victoria, TX 77901 | 2019-04-02 |
| 1871058099 | Still Water Springs | Counselor | 103 East Airline Road, Suite 3, Victoria, TX 77901 | 2019-02-01 |
| 1811488349 | Victoria Np Clinic Pllc | Nurse Practitioner | 606 E. Nueces St, Victoria, TX 77901 | 2018-05-21 |
| 1003324823 | Raul Hernandez | Physical Therapy Assistant | 101 W Goodwin Ave Ste 600, Victoria, TX 77901 | 2018-01-15 |
| 1568916153 | Bdcv / Vpsc Associates, LLC | Dietitian, Registered | 4206 N Ben Jordan Street, Victoria, TX 77901 | 2016-08-11 |
| 1801349535 | James H Jarrett Jr. | Dietitian, Registered | 4206 N. Ben Jordan Street, Victoria, TX 77901 | 2016-07-29 |
| 1508218736 | Philip Henneke | Case Manager/Care Coordinator | 1802 N. Laurent, Victoria, TX 77901 | 2016-07-12 |
| 1194084145 | Kelly E. Rogers | Speech-Language Pathologist | 2903 B. Azalea St., Victoria, TX 77901 | 2012-05-11 |
| 1023393790 | Frederick B Niegos Mdpa | Internal Medicine | 2700 Citizens Plaza, Suite 206, Victoria, TX 77901 | 2011-10-13 |
| Find all providers in zip 77901 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215391438 | Mercer Emergency Physicians Victoria Pllc | Emergency Medicine | 6902 Ne Zac Lentz Pkwy, Victoria, TX 77904-3441 | 2016-04-13 |
| 1316076482 | Boniface Gbalazeh | Emergency Medicine | 114 Sandstone Ct, Victoria, TX 77904-2952 | 2007-03-05 |
| 1457709040 | Lone Star Emergency Associates LLC | Emergency Medicine | 506 E San Antonio St, Victoria, TX 77901-6060 | 2016-05-25 |
| 1497192660 | Crossroads Hospitalist Associates, Pllc | Emergency Medicine | 506 E San Antonio St, Victoria, TX 77901-6060 | 2013-05-29 |
| 1740485697 | Victoria of Texas Lp | Emergency Medicine | 101 Medical Dr, Victoria, TX 77904-3102 | 2007-06-20 |
| 1669528329 | John W Vaughan | Emergency Medicine | 506 E San Antonio St, Victoria, TX 77901-6060 | 2007-01-26 |
| 1730239252 | Citizens Medical Center County of Victoria | Emergency Medicine | 2701 Hospital Dr, Victoria, TX 77901-5748 | 2007-01-10 |
| 1407917164 | Victoria Emergency Associates LLC | Emergency Medicine | 506 E San Antonio St, Victoria, TX 77901-6060 | 2006-12-13 |
| 1710996350 | James Rutland Brand | Emergency Medicine | 506 E San Antonio St, Victoria, TX 77901-6060 | 2006-08-05 |
| 1114936788 | Matias Relos Medina | Emergency Medicine | 506 E San Antonio St, Victoria, TX 77901-6060 | 2006-08-05 |
| Find all providers in VICTORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.