Provider Demographics
NPI:1104843838
Name:VALLEY ORTHOPEDIC & PROSTHETICS INC
Entity Type:Organization
Organization Name:VALLEY ORTHOPEDIC & PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER SECRETARY TREASUR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-888-7752
Mailing Address - Street 1:PO BOX 331580
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78463
Mailing Address - Country:US
Mailing Address - Phone:361-888-7752
Mailing Address - Fax:361-888-7424
Practice Address - Street 1:2216 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-686-0032
Practice Address - Fax:956-686-1937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000101335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168631301Medicaid
TX168631301Medicaid