Provider Demographics
NPI:1275859092
Name:BIANELLY VALDEZ
Entity Type:Organization
Organization Name:BIANELLY VALDEZ
Other - Org Name:EXPRESS CARE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BIANELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-458-1414
Mailing Address - Street 1:12209 TWIN CREEK RD STE H
Mailing Address - Street 2:
Mailing Address - City:MANCHACA
Mailing Address - State:TX
Mailing Address - Zip Code:78652-3784
Mailing Address - Country:US
Mailing Address - Phone:512-458-1414
Mailing Address - Fax:512-458-5550
Practice Address - Street 1:12209 TWIN CREEK RD STE H
Practice Address - Street 2:
Practice Address - City:MANCHACA
Practice Address - State:TX
Practice Address - Zip Code:78652-3784
Practice Address - Country:US
Practice Address - Phone:512-458-1414
Practice Address - Fax:512-458-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208482404Medicaid
TX208482402Medicaid
TX6287000001Medicare NSC