NPIMap

Organization Active NPI

Luis Valencia MD PA

  • Rural Health Clinic/Center
  • Rio Grande City, TX
National Provider Identifier
1376168708
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LUIS VALENCIA MD PA
Practice address
131 N FM 3167 Ste D
Rio Grande City, TX 78582-7009
Phone
(956) 317-1126
Fax
(956) 317-1026
NPI assigned
Jun 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Luis ValenciaNPI 1871501957
Title
MD, Owner
Phone
(956) 317-1126

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

131 N FM 3167 Ste D
Rio Grande City, TX 78582-7009

Mailing address

131 N FM 3167 Ste D
Rio Grande City, TX 78582-7009
Phone (956) 317-1126

Other names 1

  • Valley Pediatric Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200729000094 TX Part A Provider - Rural Health Clinic 4183049802 Practice locations: Rio Grande City, TX

Rural health clinic certification: CCN 673963

Legal name
LUIS VALENCIA MD PA
Doing business as
VALLEY PEDIATRIC CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 14, 2021
Last certification
Aug 21, 2024
Ownership / control type
1A
Organization structure
OtherProprietary
Incorporated
Apr 12, 2013 in TX
Enrollment address
131 N FM 3167
Ste D
Rio Grande City, TX 78582-7009

National Provider Directory

National Provider Directory
Tax ID family
Luis Valencia MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

131 N FM 3167
Ste D
Rio Grande City, TX 78582
Phone (956) 317-1126

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Luis Valencia Individual 5% Or Greater Direct Ownership Interest May 11, 2020 100%
Corporate OfficerPresident Apr 12, 2013 100%
W-2 Managing EmployeePresident Apr 12, 2013 100%
Operational/Managerial ControlPresident May 11, 2020 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Luis Valencia, M.D.
    • Pediatrics Physician
    • Rio Grande City, TX
    • NPI 1871501957

    5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1376168708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 N FM 3167 STE D",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785827009",
            "telephone_number": "956-317-1126",
            "fax_number": "956-317-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N FM 3167 STE D",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785827009",
            "telephone_number": "956-317-1126",
            "fax_number": "956-317-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS VALENCIA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "VALENCIA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "MD, OWNER",
        "authorized_official_telephone_number": "956-317-1126"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Pediatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rio Grande City, TX

Sources for this page

Verify at the official NPI Registry.