Provider Demographics
NPI:1366039901
Name:SOUTHERN TEXAS NEPHROLOGY PLLC
Entity Type:Organization
Organization Name:SOUTHERN TEXAS NEPHROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:956-212-7984
Mailing Address - Street 1:1080 E LOS EBANOS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-9988
Mailing Address - Country:US
Mailing Address - Phone:956-542-3472
Mailing Address - Fax:
Practice Address - Street 1:1080 E LOS EBANOS BLVD STE A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-9988
Practice Address - Country:US
Practice Address - Phone:956-542-3472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentGroup - Multi-Specialty