Basic Information
| Provider Information | |||||||||
| NPI: | 1265879332 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALLA | ||||||||
| FirstName: | NOREEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6210 E. US HIGHWAY 290 | ||||||||
| Address2: | SUITE 420 - CREDENTIALING | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122315506 | ||||||||
| FaxNumber: | 5124066216 | ||||||||
| Practice Location | |||||||||
| Address1: | 2100 AUTUMN SLATE DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | PFLUGERVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786606034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5129892680 | ||||||||
| FaxNumber: | 5124067339 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2013 | ||||||||
| LastUpdateDate: | 11/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Q9757 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 364792704 | 05 | TX | MEDICAID | 364792703 | 05 | TX | MEDICAID |