Provider Demographics
NPI:1053627166
Name:SOUTHWEST VALLEY MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:SOUTHWEST VALLEY MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:YRUEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-683-8066
Mailing Address - Street 1:3400 N MCCOLL RD STE 15
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5787
Mailing Address - Country:US
Mailing Address - Phone:956-683-8066
Mailing Address - Fax:956-683-8603
Practice Address - Street 1:3400 N MCCOLL RD STE 15
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5787
Practice Address - Country:US
Practice Address - Phone:956-683-8066
Practice Address - Fax:956-683-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care