Texas Avenue Medical Clinic
LBN: Texas Avenue Medical Clinic
Texas Avenue Medical Clinic is an health care organization with primary practice located at 1703 E 29Th Street , Bryan TX 77802. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Texas Avenue Medical Clinic can be contacted via phone (979) 779-4756, or through Cherian, Rany A via phone (979) 779-4756.
Contact Information
Primary practice address
1703 E 29Th Street
Bryan TX 77802
Phone: (979) 779-4756
Fax: (979) 823-3018
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | ||
| Allopathic & Osteopathic Physicians / Surgery | 208600000X |
Profile Details
| NPI number | 1942373816 |
|---|---|
| LBN Legal business name | Texas Avenue Medical Clinic |
| DBA Doing business as | |
| Authorized official | Cherian, Rany A Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 16th, 2006 |
| Last updated | Aug 21st, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942373816 | NPPES |
| Texas | MEDICAID | 091802101 |
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