Provider Demographics
NPI:1174706378
Name:VALLEY OB/GYN PA
Entity type:Organization
Organization Name:VALLEY OB/GYN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EFRAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VELA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-8383
Mailing Address - Street 1:522 E DOVE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2241
Mailing Address - Country:US
Mailing Address - Phone:956-631-8383
Mailing Address - Fax:956-631-8388
Practice Address - Street 1:522 E DOVE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2241
Practice Address - Country:US
Practice Address - Phone:956-631-8383
Practice Address - Fax:956-631-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0020LMOtherBLUE CROSS BLUE SHIELD