Provider Demographics
NPI:1467707687
Name:PALM VALLEY ANESTHESIA PLLC
Entity Type:Organization
Organization Name:PALM VALLEY ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FATIH
Authorized Official - Middle Name:
Authorized Official - Last Name:OZCELEBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-687-2673
Mailing Address - Street 1:1200 E SAVANNAH AVE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1727
Mailing Address - Country:US
Mailing Address - Phone:956-687-2673
Mailing Address - Fax:956-630-1091
Practice Address - Street 1:1200 E SAVANNAH AVE
Practice Address - Street 2:SUITE 15
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1727
Practice Address - Country:US
Practice Address - Phone:956-687-2673
Practice Address - Fax:956-630-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-14
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX307974101Medicaid
TXDT0700OtherRAILROAD MEDICARE
TX00C50ZOtherBCBS
TXTXB159758Medicare PIN