Healthcare Provider Details

I. General information

NPI: 1740119601
Provider Name (Legal Business Name): VALERIA VIVIANA BAEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 UNIVERSITY BLVD
LAREDO TX
78041-1920
US

IV. Provider business mailing address

466A PONDEROSA PL
LAREDO TX
78041-3721
US

V. Phone/Fax

Practice location:
  • Phone: 956-326-2001
  • Fax: 956-326-2889
Mailing address:
  • Phone: 956-326-2001
  • Fax: 956-326-2889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: