Poonam Vallabhbhai, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0025849 Issued in TX

Practice address

2525 N Veterans Blvd
Eagle Pass, TX 78852-3302

Phone

(830) 773-5358

Fax

(830) 773-0328

NPI assigned

Aug 26, 2010

Last updated

Dec 11, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1598071680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1470",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788531470",
            "telephone_number": "830-773-6963",
            "fax_number": "830-757-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 N VETERANS BLVD",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788523302",
            "telephone_number": "830-773-5358",
            "fax_number": "830-773-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLABHBHAI",
        "first_name": "POONAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "0025849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX STATE BOARD OF DENTAL EXAMINERS - DDS LICENSE",
            "identifier": "25849",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Val Verde County Hospital District (Maverick Nursing and Rehabilitation Center)
• Val Verde County Hospital District (La Hacienda de Paz Rehabilitation and Care Center)
• Laura Rene Valdes
• Victoriano Valdez, MD
• Miguel Angel Valencia Duarte, CRNA
• Inez Vasquez, LVN
• Kimberly Vasquez
• Elizabeth Vela, PHARMD
• Monica Vela, RPH
• Adriana Lizeth Velarde

• General Practice Dentistry in Eagle Pass, TX
• Providers in Eagle Pass, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.