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General NPI Number Information
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NPI Number | 1942246327
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Entity Type | Organization
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Legal Business Name | NUESTRA CLINICA DEL VALLE INC
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 611 N BRYAN RD
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City | MISSION
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State | TX
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Zip | 78572
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Country | US
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Telephone | 956-580-3304
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Fax | 956-524-1901
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Provider Business Mailing Address
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Address Line | PO BOX 1689
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City | PHARR
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State | TX
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Zip | 78577-1630
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Country | US
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Telephone | 956-787-0787
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Fax | 956-787-2021
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. MARIA L TORRES
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Credential |
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Telephone | 956-787-8915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | D18061
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License Number State | TX
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