Provider Demographics
NPI:1073377958
Name:VALLEY PODIATRY CENTER, PLLC
Entity Type:Organization
Organization Name:VALLEY PODIATRY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ENYEW
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:443-985-8548
Mailing Address - Street 1:3800 LA SIENNA PKWY APT 12107
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-6230
Mailing Address - Country:US
Mailing Address - Phone:443-985-8548
Mailing Address - Fax:
Practice Address - Street 1:3800 LA SIENNA PKWY APT 12107
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-6230
Practice Address - Country:US
Practice Address - Phone:443-985-8548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty