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NPI Code Detail

MEDICARE: VALLEY EAR NOSE & THROAT SPECIALIST PA

MEDICARE: VALLEY EAR NOSE & THROAT SPECIALIST PA
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
1207YX0007XPlastic Surgery within the Head & Neck (Otolaryngology) Physician
2231H00000XAudiologist
3363A00000XPhysician Assistant
4363L00000XNurse Practitioner
5207Y00000XOtolaryngology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CD5674OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100447NOTHERTXBC/BS OF TEXAS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386648798
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY EAR NOSE & THROAT SPECIALIST PA
Provider Business Mailing Address
First Line : 2101 S CYNTHIA ST
Second Line :
City : MCALLEN
State : TX
Zip : 78503-1294
Country : US
Telephone Number : 956-687-7896
Fax Number : 956-994-9694
Provider Business Practice Location Address
First Line : 2101 S CYNTHIA ST
Second Line :
City : MCALLEN
State : TX
Zip : 78503-1294
Country : US
Telephone Number : 956-687-7896
Fax Number : 956-994-9694
Authorized Official
Title or Position : PARTNER/OFFICER
Name : CHARLES THEIVAGT
Credential : MD
Telephone Number : 956-687-7896
Provider Enumeration Date : 06/13/2005
Last Update Date : 10/26/2023

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1891790945 — DR. JOSEPH HOWARD HEMER DO
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1902801988 — DR. JAMES TURNER WRIGHT MD
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Directions to “VALLEY EAR NOSE & THROAT SPECIALIST PA ” Practice Location

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