| Theresa L.valladares, M.d.p.a. | |
|
923 E Ferguson St Suite C Pharr TX 78577-2613 | |
| (956) 702-0024 | |
| (956) 702-0616 |
| Full Name | Theresa L.valladares, M.d.p.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 923 E Ferguson St, Pharr, Texas |
| Authorized Official Name and Position | Theresa Lynn Valladares (MEDICAL DOCTOR / PHYSICIAN OWNER) |
| Authorized Official Contact | 9567020024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa L.valladares, M.d.p.a. 2302 Red River Dr Mission TX 78572-7454 Ph: (956) 702-0024 | Theresa L.valladares, M.d.p.a. 923 E Ferguson St Suite C Pharr TX 78577-2613 Ph: (956) 702-0024 |
| NPI Number | 1891803078 |
|---|---|
| Provider Enumeration Date | 08/28/2006 |
| Last Update Date | 03/10/2011 |
| Medicare PECOS PAC ID | 5890733505 |
|---|---|
| Medicare Enrollment ID | O20050422000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891803078 | NPI | - | NPPES |
| 0084PU | Other | TX | BCBS GROUP # |
| 148012102 | Medicaid | TX | |
| 0011MP | Other | TX | BCBS PROVIDER # |
| 173167101 | Medicaid | TX | |
| 173167102 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Theresa Valladares |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568578326 PECOS PAC ID: 3173585064 Enrollment ID: I20041102001120 |
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