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Organization
PRAIRIE VIEW A&M UNIVERSITY
Active
Organization
PRAIRIE VIEW A&M UNIVERSITY
Active
Other names
Owens-Franklin Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN E BERRY M.D. (MEDICAL DIRECTOR)
(936) 261-1410
Entity
Organization
Contact information
Practice address
1125 REDA BLAND & OJ BAKER ST, PRAIRIE VIEW, TX 77446
(936) 261-1410
(936) 261-1452
Mailing address
P.O. BOX 519 MS 1413, PRAIRIE VIEW, TX 77446
(936) 261-1410
(936) 261-1452
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D1052515
CLIA
TX
Enumeration date
12/11/2006
Last updated
06/11/2018
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