Provider Demographics
NPI:1124006390
Name:VALLEY NIGHT CLINIC LLP
Entity type:Organization
Organization Name:VALLEY NIGHT CLINIC LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-682-4515
Mailing Address - Street 1:606 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4906
Mailing Address - Country:US
Mailing Address - Phone:956-682-4515
Mailing Address - Fax:956-682-4143
Practice Address - Street 1:606 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4906
Practice Address - Country:US
Practice Address - Phone:956-682-4515
Practice Address - Fax:956-682-4143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100907801Medicaid
TX115875003Medicaid
TX100908601Medicaid
TX085088501Medicaid
TX100906002Medicaid
TXB25948Medicare UPIN
TXB21099Medicare UPIN
TX891283Medicare ID - Type UnspecifiedGUERRA
TX891286Medicare ID - Type UnspecifiedMORENO
TX891278Medicare ID - Type UnspecifiedRIVAS
TXSN88Medicare ID - Type UnspecifiedGROUP
TX891277Medicare ID - Type UnspecifiedBARRERA
TX085088501Medicaid
TX115875003Medicaid