Provider Demographics
NPI:1376168708
Name:LUIS VALENCIA MD PA
Entity Type:Organization
Organization Name:LUIS VALENCIA MD PA
Other - Org Name:VALLEY PEDIATRIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-317-1126
Mailing Address - Street 1:131 N FM 3167 STE D
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-7009
Mailing Address - Country:US
Mailing Address - Phone:956-317-1126
Mailing Address - Fax:956-317-1026
Practice Address - Street 1:131 N FM 3167 STE D
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-7009
Practice Address - Country:US
Practice Address - Phone:956-317-1126
Practice Address - Fax:956-317-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health