Provider Demographics
NPI:1508135609
Name:SPRING VALLEY PRIMARY CARE, P.A.
Entity Type:Organization
Organization Name:SPRING VALLEY PRIMARY CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-781-0844
Mailing Address - Street 1:1220 BLALOCK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6473
Mailing Address - Country:US
Mailing Address - Phone:713-781-0844
Mailing Address - Fax:713-781-1350
Practice Address - Street 1:1220 BLALOCK RD STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6473
Practice Address - Country:US
Practice Address - Phone:713-781-0844
Practice Address - Fax:713-781-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1502207Q00000X
TXJ7040207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350445801Medicaid
TX4995460OtherAETNA
TX003AAXOtherBSBS
TX003AAXOtherBSBS