| Organization Name: | JK SUN VALLEY HEALTHCARE ASSOCIATES PA |
| NPI Number: | 1750317228 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KHADIM HUSSAIN (OWNER) |
| Mailing Address: | 2686 W Alton Gloor Blvd Suite 1 Brownsville |
| State: | TX US |
| Postal Code: | 785204055 |
| Phone Number: | 9563505444 |
| Fax Number: | 9563502493 |
| NPI Enumeration Date: | 06/24/2006 |
| NPI Last Update Date: | 05/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |