# UPPER VALLEY PEDIATRIC AND ADOLESCENT HEALTHCARE CLINIC PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528235132
- **Authorized official:** DR. ROEL ESTEBAN CANTU MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (956) 787-8100

## Contact information

- **Practice address:** 411 WEST FM 495, SAN JUAN, TX 78589-7419
- **Practice address phone:** (956) 787-8100
- **Practice address fax:** (956) 787-8117
- **Mailing address:** PO BOX 2419, SAN JUAN, TX 78589-7419
- **Mailing address phone:** (956) 787-8100
- **Mailing address fax:** (956) 787-8117

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/13/2008
- **Last updated:** 07/29/2010