Provider Demographics
NPI:1124061387
Name:RIO GRANDE VALLEY DME INC.
Entity type:Organization
Organization Name:RIO GRANDE VALLEY DME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOISES
Authorized Official - Middle Name:
Authorized Official - Last Name:SALDIVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-683-1655
Mailing Address - Street 1:2209 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-6128
Mailing Address - Country:US
Mailing Address - Phone:956-683-1655
Mailing Address - Fax:956-683-7655
Practice Address - Street 1:2209 N 23RD ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6128
Practice Address - Country:US
Practice Address - Phone:956-683-1655
Practice Address - Fax:956-683-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168768302Medicaid
TX183971402Medicaid
TX168768301Medicaid
TX183971401Medicaid
TX5789960001Medicare NSC