MEDICARE: VALLEY PICC LINES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QI0500X	Infusion Therapy Clinic/Center

General Provider Information

NPI Number	:	1295029544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY PICC LINES

Provider Business Mailing Address
First Line	:	5460 PAREDES LINE RD STE 206
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78526-9741
Country	:	US
Telephone Number	:	956-455-2100
Fax Number	:	956-350-0837

Provider Business Practice Location Address
First Line	:	5460 PAREDES LINE RD STE 206
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78526-9741
Country	:	US
Telephone Number	:	956-455-2100
Fax Number	:	956-350-0837

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	CESAR R PEREZ
Credential	:
Telephone Number	:	956-455-2100

Provider Enumeration Date	:	06/03/2011
Last Update Date	:	06/03/2011

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Directions to “VALLEY PICC LINES ” Practice Location

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