Healthcare Provider Details

I. General information

NPI: 1750308482
Provider Name (Legal Business Name): VALLEY ORTHOPEDIC & PROSTHETICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E HWY 77
SAN BENITO TX
78586
US

IV. Provider business mailing address

PO BOX 331580
CORPUS CHRISTI TX
78463
US

V. Phone/Fax

Practice location:
  • Phone: 956-399-1129
  • Fax: 956-399-1360
Mailing address:
  • Phone: 361-888-7752
  • Fax: 361-888-7424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number000102
License Number StateTX

VIII. Authorized Official

Name: MRS. ANGELA M SEARS
Title or Position: CORP OFFICER SECRETARY TREASURER
Credential:
Phone: 361-888-7752