Healthcare Provider Details

I. General information

NPI: 1467845768
Provider Name (Legal Business Name): OLIVER VALDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2015
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 E 8TH ST STE 1
WESLACO TX
78596-7120
US

IV. Provider business mailing address

1200 GRANDE OAK BLVD APT 207
SARALAND AL
36571-3717
US

V. Phone/Fax

Practice location:
  • Phone: 956-687-4560
  • Fax:
Mailing address:
  • Phone: 251-214-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH7386
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: