Paul Vance, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

T9521 Issued in TX

Practice address

864 Central Blvd Ste 3000
Brownsville, TX 78520-7593

Phone

(956) 546-7546

NPI assigned

Mar 19, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rio Valley Dermatology, PA

  • Dermatology Physician
  • Brownsville, TX
  • NPI 1548491863
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1104402213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 CENTRAL BLVD STE 3000",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785207593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 CENTRAL BLVD STE 3000",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785207593",
            "telephone_number": "956-546-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-19",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "T9521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Primary Care PLLC
• Valley Provider Services LLC
• Valley Residential Corp
• Valleywide Pharmacy and DME Inc
• Valleywide Pharmacy and DME Inc
• Dominique Vande Maele, M.D.
• Laura Vanderford, O.T.
• Vanesa G Clements DDS PC
• Brandon David Vanornum, PTA
• Vantage Emergency Physicians, PLLC

• Dermatology Physician in Brownsville, TX
• Providers in Brownsville, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.