Provider Demographics
NPI:1376109637
Name:VALLEY DIABETES & ENDOCRINOLOGY COMPREHENSIVE CENTER P.L.L.C.
Entity type:Organization
Organization Name:VALLEY DIABETES & ENDOCRINOLOGY COMPREHENSIVE CENTER P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-603-1555
Mailing Address - Street 1:7017 N 10TH ST. STE N-2 #218
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:956-603-1555
Mailing Address - Fax:956-800-6369
Practice Address - Street 1:4113 CROSSPOINT BLVD STE 11
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1803
Practice Address - Country:US
Practice Address - Phone:956-603-1555
Practice Address - Fax:956-800-6369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty