# PRAIRIE VIEW A&M UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Owens-Franklin Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639239874
- **Authorized official:** GLENN E BERRY M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (936) 261-1410

## Contact information

- **Practice address:** 1125 REDA BLAND & OJ BAKER ST, PRAIRIE VIEW, TX 77446
- **Practice address phone:** (936) 261-1410
- **Practice address fax:** (936) 261-1452
- **Mailing address:** P.O. BOX 519 MS 1413, PRAIRIE VIEW, TX 77446
- **Mailing address phone:** (936) 261-1410
- **Mailing address fax:** (936) 261-1452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 06/11/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 45D1052515 | CLIA | TX |