Provider Demographics
NPI:1558496778
Name:OSCAR VILLEDA, ALEJANDRO VILLEDA
Entity Type:Organization
Organization Name:OSCAR VILLEDA, ALEJANDRO VILLEDA
Other - Org Name:MID VALLEY PRIMARY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-973-1713
Mailing Address - Street 1:PO BOX 8322
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-8322
Mailing Address - Country:US
Mailing Address - Phone:956-973-1713
Mailing Address - Fax:956-973-1759
Practice Address - Street 1:3708 EAST BUSINESS 83
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537
Practice Address - Country:US
Practice Address - Phone:956-973-1713
Practice Address - Fax:956-973-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010191251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health