VICTORIA OF TEXAS LP (NPI# 1740485697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740485697 |
| Entity Type | Organization |
| Organization Name | VICTORIA OF TEXAS LP |
| Other Organization Name | DETAR HOSPITAL NORTH EMERGENCY DEPARTMENT |
| Practice Address |
101 Medical Dr Victoria TX 77904-3102 |
| Mailing Address |
Po Box 689022 Franklin TN 37068-9022 |
| Practice Telephone | 3615736100 |
| Practice Fax Number | 3617882693 |
| 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 | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 143687501 | 05 | |
| BLUE CROSS | 00401R | 01 | |
| TX | 143687502 | 05 |
| Other Name | Type Code |
|---|---|
| DeTar Hospital North Emergency Department | 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 |
| 1619172467 | Victoria of Texas Lp | Family Medicine | 605 E San Antonio St, Suite 310e, Victoria, TX 77901-6040 | 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 |
101 MEDICAL DR |
| City | VICTORIA |
| State | TX |
| Zip Code | 77904-3102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427338508 | Victoria of Texas Lp | Psychiatric Unit | 101 Medical Dr, Victoria, TX 77904-3102 | 2011-08-22 |
| 1942468541 | Sartaj Kadiwala Siddiqui | Pediatrics | 101 Medical Dr, Victoria, TX 77904-3102 | 2008-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528600384 | Bertha P Mendieta | Physician Assistant | Citizens Victoria Surgical Associates, 2705 Hospital Drive Suite 400, Building B, Victoria, TX 77904 | 2019-10-14 |
| 1952968901 | Eliza Welder | Counselor | 6502 Nursery Dr. Suite, Suite 100, Victoria, TX 77904 | 2019-05-24 |
| 1154806529 | Tammy Lynn Hogan | Counselor | 4702 N. Laurent Ste D, Victoria, TX 77904 | 2018-10-01 |
| 1740724939 | Sarah Ritchea | Counselor | 6502 Nursery Dr. Suite 100, Victoria, TX 77904 | 2016-12-07 |
| 1992177489 | World of Words Speech & Feeding Services, LLC | Speech-Language Pathologist | 120 Appaloosa Dr., Victoria, TX 77904 | 2015-10-23 |
| 1396115739 | Katelin Mcvey | Physician Assistant | 106 Springwood Drive, Suite 100, Victoria, TX 77904 | 2015-09-28 |
| 1689070062 | Jeremy M Thompson Dds Ms Pllc | Clinic/Center | 103 Professional Park Driv, Victoria, TX 77904 | 2014-11-12 |
| 1265864144 | Pf Development 23, LLC | Hospice Care, Community Based | 1501 E Mockingbird Ln Ste 301b, Victoria, TX 77904 | 2013-08-02 |
| 1053669762 | Victoria Dentistry, Pllc | Dentist | 8809 North Navarro, Ste.100, Victoria, TX 77904 | 2012-08-28 |
| 1508126442 | Ayo Adu, M.d., Pllc | Family Medicine | 9410 Ne Zac Lentz Parkway, Suite 200, Victoria, TX 77904 | 2012-05-25 |
| Find all providers in zip 77904 | ||||
| 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 |
| 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 |
| 1235144676 | Clyde Walrod | Emergency Medicine | 2701 Hospital Dr, Victoria, TX 77901-5748 | 2006-07-31 |
| 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.