Clinica Hispana, P.a. | |
2028 Wirt Rd Houston TX 77055-1602 | |
(713) 682-7066 | |
(832) 916-2813 |
Full Name | Clinica Hispana, P.a. |
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Speciality | Family Medicine |
Location | 2028 Wirt Rd, Houston, Texas |
Authorized Official Name and Position | Oscar L De Valle (PHYSICIAN) |
Authorized Official Contact | 7136827066 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clinica Hispana, P.a. 2028 Wirt Rd Houston TX 77055-1602 Ph: (713) 682-7066 | Clinica Hispana, P.a. 2028 Wirt Rd Houston TX 77055-1602 Ph: (713) 682-7066 |
NPI Number | 1053326629 |
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Provider Enumeration Date | 07/30/2006 |
Last Update Date | 10/19/2019 |
Medicare PECOS PAC ID | 9830087394 |
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Medicare Enrollment ID | O20040306000147 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053326629 | NPI | - | NPPES |
111512302 | Other | TX | EPSDT |
111512301 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Provider Name | Oscar L De Valle |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669415196 PECOS PAC ID: 0941196166 Enrollment ID: I20040225000666 |
Provider Name | Nixcela Ares-valdes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902002801 PECOS PAC ID: 4486839438 Enrollment ID: I20110506000286 |
Provider Name | Ricardo Grillo-paris |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1316984735 PECOS PAC ID: 1052656410 Enrollment ID: I20181213001199 |
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