Provider Demographics
NPI:1962015180
Name:VALLEY PRIMARY CARE PLLC
Entity Type:Organization
Organization Name:VALLEY PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-727-6319
Mailing Address - Street 1:7089 POST OAK CIR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3074
Mailing Address - Country:US
Mailing Address - Phone:561-727-6319
Mailing Address - Fax:
Practice Address - Street 1:7089 POST OAK CIR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3074
Practice Address - Country:US
Practice Address - Phone:561-727-6319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-27
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty