Provider Demographics
NPI:1225289218
Name:VALLEY CARDIOTHORACIC SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:VALLEY CARDIOTHORACIC SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-350-6121
Mailing Address - Street 1:P.O BOX 3847
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-350-6121
Mailing Address - Fax:956-350-6125
Practice Address - Street 1:425 E. LOS EBANOS BLVD STE-103
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-350-6121
Practice Address - Fax:956-350-6125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF34312086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033900401Medicaid
TX00HR31Medicare PIN