MEDICARE: GV CLINIC, PLLC

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	N7365	TX

General Provider Information

NPI Number	:	1760991830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GV CLINIC, PLLC

Provider Business Mailing Address
First Line	:	3160 N TARRANT PKWY STE 404
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76177-8614
Country	:	US
Telephone Number	:	469-629-5031
Fax Number	:	888-992-6199

Provider Business Practice Location Address
First Line	:	3160 N TARRANT PKWY STE 404
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76177-8614
Country	:	US
Telephone Number	:	469-629-5031
Fax Number	:	888-992-6199

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK C VALENTE
Credential	:	DO
Telephone Number	:	214-384-1642

Provider Enumeration Date	:	09/21/2017
Last Update Date	:	07/21/2022

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