Healthcare Provider Details

I. General information

NPI: 1891756938
Provider Name (Legal Business Name): ANDREA Y VALLE LERMA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S RANGERVILLE RD
HARLINGEN TX
78552-7638
US

IV. Provider business mailing address

104 E WISTERIA AVE
MCALLEN TX
78504-2322
US

V. Phone/Fax

Practice location:
  • Phone: 956-364-8000
  • Fax: 956-364-8497
Mailing address:
  • Phone: 956-618-0856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number223034
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: