Healthcare Provider Details

I. General information

NPI: 1235500505
Provider Name (Legal Business Name): ARTURO VALLES PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 IOLA AVE
LUBBOCK TX
79424-7845
US

IV. Provider business mailing address

2808 87TH ST
LUBBOCK TX
79423-3106
US

V. Phone/Fax

Practice location:
  • Phone: 806-687-6640
  • Fax:
Mailing address:
  • Phone: 432-889-0422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1247407
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: