Provider Demographics
NPI:1588442321
Name:PALM VALLEY BRAIN AND SPINE LLC
Entity type:Organization
Organization Name:PALM VALLEY BRAIN AND SPINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOHUM
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-655-1961
Mailing Address - Street 1:1019 S UTAH AVE STE C
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-5588
Mailing Address - Country:US
Mailing Address - Phone:956-647-5000
Mailing Address - Fax:956-375-2010
Practice Address - Street 1:1019 S UTAH AVE STE C
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5588
Practice Address - Country:US
Practice Address - Phone:956-647-5000
Practice Address - Fax:956-375-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty