Provider Demographics
NPI:1447319470
Name:ADOLFO VALADEZ DBA CIRCLE OF FRIENDS IV
Entity type:Organization
Organization Name:ADOLFO VALADEZ DBA CIRCLE OF FRIENDS IV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADOLFO
Authorized Official - Middle Name:
Authorized Official - Last Name:VALADEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-383-4991
Mailing Address - Street 1:RR 6 BOX 535B
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8907
Mailing Address - Country:US
Mailing Address - Phone:956-383-4991
Mailing Address - Fax:
Practice Address - Street 1:301 S WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-3323
Practice Address - Country:US
Practice Address - Phone:956-361-1468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010371261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health