| Valley Diabetes & Endocrinology Comprehensive Center P.l.l.c. | |
|
4113 Crosspoint Blvd Ste 11 Edinburg TX 78539-1803 | |
| (956) 603-1555 | |
| (956) 800-6369 |
| Full Name | Valley Diabetes & Endocrinology Comprehensive Center P.l.l.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4113 Crosspoint Blvd Ste 11, Edinburg, Texas |
| Authorized Official Name and Position | Alejandro Gonzalez Campos (PRESIDENT) |
| Authorized Official Contact | 9566031555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Diabetes & Endocrinology Comprehensive Center P.l.l.c. 7017 N 10th St. Ste N-2 #218 Mcallen TX 78504 Ph: (956) 603-1555 | Valley Diabetes & Endocrinology Comprehensive Center P.l.l.c. 4113 Crosspoint Blvd Ste 11 Edinburg TX 78539-1803 Ph: (956) 603-1555 |
| NPI Number | 1376109637 |
|---|---|
| Provider Enumeration Date | 05/13/2019 |
| Last Update Date | 06/24/2020 |
| Medicare PECOS PAC ID | 9234467457 |
|---|---|
| Medicare Enrollment ID | O20190827001157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376109637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Pamela Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952474397 PECOS PAC ID: 1254433105 Enrollment ID: I20131015000339 |
| Provider Name | Jose A Llinas Cepeda |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1164652533 PECOS PAC ID: 0244456986 Enrollment ID: I20140801000517 |
| Provider Name | Mayra Judith Cantazaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619386190 PECOS PAC ID: 4688896954 Enrollment ID: I20141121000570 |
| Provider Name | Alejandro Gonzalez Campos |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1508130543 PECOS PAC ID: 2466747647 Enrollment ID: I20160826001626 |
| Provider Name | Eduardo Dusty Luna |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1073959326 PECOS PAC ID: 2062702707 Enrollment ID: I20180831000934 |
| Provider Name | Amanda Cantu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1093102923 PECOS PAC ID: 7810282639 Enrollment ID: I20200714001110 |
| Provider Name | Mark Elijah Fankhauser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841906005 PECOS PAC ID: 3375986318 Enrollment ID: I20240207001496 |
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