Provider Demographics
NPI:1710334156
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 ROAD
Mailing Address - Street 2:SUITE 250
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
Practice Address - Street 2:SUITE 250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6472
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:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB155791Medicare PIN