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General NPI Number Information
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NPI Number | 1366039901
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Entity Type | Organization
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Legal Business Name | SOUTHERN TEXAS NEPHROLOGY PLLC
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 1080 E LOS EBANOS BLVD STE A
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9988
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Country | US
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Telephone | 956-542-3472
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Fax |
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Provider Business Mailing Address
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Address Line | 1080 E LOS EBANOS BLVD STE A
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9988
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Country | US
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Telephone | 956-542-3472
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REUBEN VALENTIN JR.
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Credential | MD
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Telephone | 956-212-7984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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