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General NPI Number Information
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NPI Number | 1194345405
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Entity Type | Organization
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Legal Business Name | UPPER VALLEY FAMILY CLINIC, PLLC
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Dates
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Enumeration Date | 04/16/2020
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Last Update Date | 09/27/2020
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Provider Practice Location Address
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Address Line | 1156 W MONTE CRISTO RD
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City | EDINBURG
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State | TX
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Zip | 78541-4541
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Country | US
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Telephone | 956-460-5099
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Fax |
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Provider Business Mailing Address
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Address Line | 1156 W MONTE CRISTO RD STE B
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City | EDINBURG
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State | TX
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Zip | 78541-4541
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Country | US
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Telephone | 956-609-9339
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. NILDA DIANNE RODRIGUEZ
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Credential | APRN, FNP-C
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Telephone | 956-609-9339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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