| Clinica Hispana Ii, P.a. | |
|
8410 Fondren Rd Houston TX 77074-5616 | |
| (713) 484-7455 | |
| (713) 484-8016 |
| Full Name | Clinica Hispana Ii, P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 8410 Fondren Rd, Houston, Texas |
| Authorized Official Name and Position | Oscar L De Valle (PHYSICIAN) |
| Authorized Official Contact | 7134847455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Hispana Ii, P.a. 8410 Fondren Rd Houston TX 77074-5616 Ph: (713) 484-7455 | Clinica Hispana Ii, P.a. 8410 Fondren Rd Houston TX 77074-5616 Ph: (713) 484-7455 |
| NPI Number | 1154336733 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 04/23/2018 |
| Medicare PECOS PAC ID | 7517853724 |
|---|---|
| Medicare Enrollment ID | O20040225000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154336733 | NPI | - | NPPES |
| 1646507-02 | Other | TX | EPSDT |
| 164650701 | Medicaid | TX | |
| 164650703 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Oscar L De Valle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669415196 PECOS PAC ID: 0941196166 Enrollment ID: I20040225000666 |
| Provider Name | Nixcela Ares-valdes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902002801 PECOS PAC ID: 4486839438 Enrollment ID: I20110506000286 |
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