Healthcare Provider Details

I. General information

NPI: 1093329583
Provider Name (Legal Business Name): ELISA VALDEZ PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14887 SOUTHWEST FWY
SUGAR LAND TX
77478-5016
US

IV. Provider business mailing address

21203 PALM ARBOR DR
CYPRESS TX
77433-6932
US

V. Phone/Fax

Practice location:
  • Phone: 281-565-8099
  • Fax: 281-565-9637
Mailing address:
  • Phone: 713-828-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA02845
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: