MEDICARE: THERESE VALLINA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	141016	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	141016	OTHER	TN	RN

General Provider Information

NPI Number	:	1003030180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESE VALLINA RN

Provider Business Mailing Address
First Line	:	3600 ALMA RD APT 3818
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-1122
Country	:	US
Telephone Number	:	214-645-7083
Fax Number	:

Provider Business Practice Location Address
First Line	:	5939 HARRY HINES BLVD SUITE HQ7.711
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-3784
Country	:	US
Telephone Number	:	214-645-7083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/09/2025

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