Provider Demographics
NPI:1265998256
Name:BREEZE VALENSKA CERVANTES PLLC
Entity type:Organization
Organization Name:BREEZE VALENSKA CERVANTES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BREEZE
Authorized Official - Middle Name:
Authorized Official - Last Name:CERVANTES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:361-455-9332
Mailing Address - Street 1:745 E SAINT CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-5219
Mailing Address - Country:US
Mailing Address - Phone:361-455-9332
Mailing Address - Fax:
Practice Address - Street 1:745 E SAINT CHARLES ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-5219
Practice Address - Country:US
Practice Address - Phone:361-455-9332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty