Healthcare Provider Details

I. General information

NPI: 1578916797
Provider Name (Legal Business Name): MARGARET E VALDEZ PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET VALDEZ NAVARRETTE PTA

II. Dates (important events)

Enumeration Date: 07/22/2016
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 COPPER AVE NE
ALBUQUERQUE NM
87108-1473
US

IV. Provider business mailing address

1492 CALLE CIELO VIS
BERNALILLO NM
87004-9147
US

V. Phone/Fax

Practice location:
  • Phone: 505-266-5557
  • Fax:
Mailing address:
  • Phone: 505-818-3869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA-1124
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: