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General NPI Number Information
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NPI Number | 1982884284
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Entity Type | Organization
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Legal Business Name | UPPER VALLEY PEDIATRICS, PLLC
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 615 E UNIVERSITY DR
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City | EDINBURG
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State | TX
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Zip | 78539-3626
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Country | US
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Telephone | 956-316-4416
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Fax | 956-316-4434
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Provider Business Mailing Address
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Address Line | 832 DEL ORO LN SUITE 2
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City | PHARR
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State | TX
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Zip | 78577-2200
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Country | US
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Telephone | 956-787-2500
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Fax | 956-787-2528
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SERGIO GUSTAVO PRECIADO
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Credential | M.D.
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Telephone | 956-787-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J9278
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License Number State | TX
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