Organization Active NPI

Upper Valley Pediatrics, PLLC

  • Pediatrics Physician
  • Edinburg, TX
National Provider Identifier
1982884284
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J9278 Issued in TX
Legal business name
UPPER VALLEY PEDIATRICS, PLLC
Doing business as
University Pediatrics
Practice address
615 E University Dr
Edinburg, TX 78539-3626
Phone
(956) 316-4416
Fax
(956) 316-4434
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Authorized official

Name
Dr. Sergio Gustavo Preciado, M.D.
Title
President
Phone
(956) 787-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X J9278 TX Primary

Addresses

Primary practice location

615 E University Dr
Edinburg, TX 78539-3626

Mailing address

832 Del Oro LN
Suite 2
Pharr, TX 78577-2200
Phone (956) 787-2500

Other identifiers 2

IdentifierTypeStateIssuer
195075001MedicaidTX
195075002MedicaidTX

Other names 1

  • University Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0952507University Pediatrics615 East University Drive, Edinburg, TX 78539ComplianceSep 30, 2027

National Provider Directory

National Provider Directory

Locations

615 E University Dr
Edinburg, TX 78539
Phone (956) 316-4416

Practitioners & affiliated clinicians

Practitioners 2

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": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1982884284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 DEL ORO LN",
            "address_2": "SUITE 2",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785772200",
            "telephone_number": "956-787-2500",
            "fax_number": "956-787-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393626",
            "telephone_number": "956-316-4416",
            "fax_number": "956-316-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER VALLEY PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "PRECIADO",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_middle_name": "GUSTAVO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-787-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J9278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195075001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195075002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.