| NAME |
BRYAN VA CLINIC |
| STATE |
TEXAS |
| STREET ADDR. 1 |
1651 ROCK PRAIRIE ROAD, SUITE 100 |
| CITY |
COLLEGE STATION |
| ZIP |
77845-8652 |
| OFFICIAL VA NAME |
BRYAN VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
COLLEGE STATION VA CBOC |
| ST. ADDR. 1 (MAILING) |
1651 ROCK PRAIRIE ROAD, SUITE 100 |
| CITY (MAILING) |
COLLEGE STATION |
| STATE (MAILING) |
TEXAS |
| ZIP (MAILING) |
77845-8652 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1609828771
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
674GC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1609828771
-
- CODING SYSTEM: VASTANUM
- ID: 674GC
-
- CODING SYSTEM: CLIA
- ID: 45D1006104
|
