Theresa L.valladares, M.d.p.a. | |
923 E Ferguson St Suite C Pharr TX 78577-2613 | |
(956) 702-0024 | |
(956) 702-0616 |
Full Name | Theresa L.valladares, M.d.p.a. |
---|---|
Speciality | Family Medicine |
Location | 923 E Ferguson St, Pharr, Texas |
Authorized Official Name and Position | Theresa Lynn Valladares (MEDICAL DOCTOR / PHYSICIAN OWNER) |
Authorized Official Contact | 9567020024 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Theresa L.valladares, M.d.p.a. 2302 Red River Dr Mission TX 78572-7454 Ph: (956) 702-0024 | Theresa L.valladares, M.d.p.a. 923 E Ferguson St Suite C Pharr TX 78577-2613 Ph: (956) 702-0024 |
NPI Number | 1891803078 |
---|---|
Provider Enumeration Date | 08/28/2006 |
Last Update Date | 03/10/2011 |
Medicare PECOS PAC ID | 5890733505 |
---|---|
Medicare Enrollment ID | O20050422000512 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891803078 | NPI | - | NPPES |
0084PU | Other | TX | BCBS GROUP # |
148012102 | Medicaid | TX | |
0011MP | Other | TX | BCBS PROVIDER # |
173167101 | Medicaid | TX | |
173167102 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Theresa Valladares |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568578326 PECOS PAC ID: 3173585064 Enrollment ID: I20041102001120 |
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