Organization
CLINICA HISPANA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR L DE VALLE M.D. (PHYSICIAN)
(713) 682-7066
Entity
Organization
Contact information
Practice address
2028 WIRT RD, HOUSTON, TX 77055-1602
(713) 682-7066
(832) 916-2813
Mailing address
2028 WIRT RD, HOUSTON, TX 77055-1602
(713) 682-7066
(832) 916-2813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111512301
—
TX
01
—
111512302
EPSDT
TX
Enumeration date
07/30/2006
Last updated
10/19/2019
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