Healthcare Provider Details
I. General information
NPI: 1083407399
Provider Name (Legal Business Name): JANET MONIC VALENZUELA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/28/2025
Last Update Date: 09/28/2025
Certification Date: 09/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7509 MARSHA SHARP FWY
LUBBOCK TX
79407-8202
US
IV. Provider business mailing address
2696 W APPLEBROOK LN APT 1-105
OAK CREEK WI
53154-8825
US
V. Phone/Fax
- Phone: 806-725-4000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367H00000X |
| Taxonomy | Anesthesiologist Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: