Provider Demographics
NPI:1295075927
Name:LAREDO NEPHROLOGISTS PLLC
Entity type:Organization
Organization Name:LAREDO NEPHROLOGISTS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9362
Mailing Address - Street 1:2325 E SAUNDERS ST
Mailing Address - Street 2:PLAZA TWO
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5434
Mailing Address - Country:US
Mailing Address - Phone:956-723-4673
Mailing Address - Fax:956-723-3133
Practice Address - Street 1:2325 E SAUNDERS ST
Practice Address - Street 2:PLAZA TWO
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5434
Practice Address - Country:US
Practice Address - Phone:956-723-4673
Practice Address - Fax:956-723-3133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-16
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1295075927Medicaid