Provider Demographics
NPI:1235678699
Name:VALLEY MENTAL CARE PLLC
Entity Type:Organization
Organization Name:VALLEY MENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NNENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUBAJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-230-4837
Mailing Address - Street 1:PO BOX 533291
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-3291
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:722 MORGAN BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5139
Practice Address - Country:US
Practice Address - Phone:956-230-4837
Practice Address - Fax:956-230-4837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-18
Last Update Date:2017-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132741363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty