Organization
CLINICA HISPANA II, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR L DE VALLE M.D. (PHYSICIAN)
(713) 484-7455
Entity
Organization
Contact information
Practice address
8410 FONDREN RD, HOUSTON, TX 77074-5616
(713) 484-7455
(713) 484-8016
Mailing address
8410 FONDREN RD, HOUSTON, TX 77074-5616
(713) 484-7455
(713) 484-8016
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1646507-02
EPSDT
TX
05
—
164650701
—
TX
05
—
164650703
—
TX
Enumeration date
07/30/2006
Last updated
04/23/2018
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