Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Other names
Texas DSHS- Rio Grande State Center STHCS, Rio Grande State Center
Organization subpart
No
Provider details
NPI number
Authorized official
JANA JOHNSON (PROGRAM SUPERVISOR VI)
(512) 438-3124
Entity
Organization
Contact information
Practice address
1401 S RANGERVILLE RD, HARLINGEN, TX 78552-7638
(956) 425-8900
(210) 531-8172
Mailing address
PO BOX 2668, HARLINGEN, TX 78551-2668
(956) 425-8900
(210) 531-8172
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212193-01
—
TX
05
—
0212193-03
—
TX
05
—
02312193-02
—
TX
05
—
0845315-01
—
TX
01
—
4521642
PHARMACY NCPDP NUMBER
TX
01
—
HH3020
BCBS DRUG ALCOHOL
TX
01
—
HH4992
BCBS PSYCHIATRIC
TX
Enumeration date
11/16/2006
Last updated
07/31/2019
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