Healthcare Provider Details

I. General information

NPI: 1669925764
Provider Name (Legal Business Name): VALERIA FLEMING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VALERIA CORDERO

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8627 CINNAMON CREEK DR STE 402
SAN ANTONIO TX
78240-1482
US

IV. Provider business mailing address

8627 CINNAMON CREEK DR STE 402
SAN ANTONIO TX
78240-1482
US

V. Phone/Fax

Practice location:
  • Phone: 210-892-0359
  • Fax: 210-253-9355
Mailing address:
  • Phone: 210-892-0359
  • Fax: 210-253-9355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3119518
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: