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General NPI Number Information
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NPI Number | 1588442321
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Entity Type | Organization
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Legal Business Name | PALM VALLEY BRAIN AND SPINE LLC
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 1019 S UTAH AVE STE C
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City | WESLACO
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State | TX
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Zip | 78596-5588
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Country | US
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Telephone | 956-647-5000
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Fax | 956-375-2010
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Provider Business Mailing Address
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Address Line | 1019 S UTAH AVE STE C
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City | WESLACO
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State | TX
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Zip | 78596-5588
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Country | US
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Telephone | 956-647-5000
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Fax | 956-375-2010
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL, PRESIDENT
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Name | SOHUM DESAI
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Credential | MD
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Telephone | 956-655-1961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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