Basic Information
| Provider Information | |||||||||
| NPI: | 1124337225 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TROPICAL TEXAS BEHAVIORAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 S 24TH AVE | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785396533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562897000 | ||||||||
| FaxNumber: | 9565130409 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 S 24TH AVE | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785396533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562897000 | ||||||||
| FaxNumber: | 9565130409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2010 | ||||||||
| LastUpdateDate: | 10/07/2019 | ||||||||
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| AuthorizedOfficialLastName: | TREJO | ||||||||
| AuthorizedOfficialFirstName: | BEATRIZ | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9562897000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 3277 | TX | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
ID Information
| ID | Type | State | Issuer | Description | 138708602 | 05 | TX | MEDICAID | 138708611 | 05 | TX | MEDICAID | 138708613 | 05 | TX | MEDICAID | 138708601 | 05 | TX | MEDICAID | 138708610 | 05 | TX | MEDICAID |