Provider Demographics
NPI:1831250430
Name:VALLEY HEMORRHOID CLINIC, P.A.
Entity type:Organization
Organization Name:VALLEY HEMORRHOID CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COLON & RECTAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PASTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-541-4441
Mailing Address - Street 1:880 RIDGEWOOD ST
Mailing Address - Street 2:2
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78550
Mailing Address - Country:US
Mailing Address - Phone:956-541-4441
Mailing Address - Fax:956-541-5474
Practice Address - Street 1:880 RIDGEWOOD ST
Practice Address - Street 2:2
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-541-4441
Practice Address - Fax:956-541-5474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1811208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035865701Medicaid
B20891Medicare UPIN
TX00SH01Medicare ID - Type Unspecified