Healthcare Provider Details
I. General information
NPI: 1538167549
Provider Name (Legal Business Name): VALLEY PM&R SPECIALISTS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2005
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 E SAVANNAH AVE STE 10
MCALLEN TX
78503-1727
US
IV. Provider business mailing address
1200 E SAVANNAH AVE STE 10
MCALLEN TX
78503-1727
US
V. Phone/Fax
- Phone: 956-668-9900
- Fax: 956-668-9902
- Phone: 956-668-9900
- Fax: 956-668-9902
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | J9418 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
SAROJA
VISWAMITRA
Title or Position: OWNER
Credential: MD
Phone: 956-668-9900