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NPI 1063514362

NPI 1063514362 : J MICHAEL VALENZA DPM : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1063514362
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    Entity Type          |    Individual 
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    Provider Name        |    J MICHAEL VALENZA DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/05/2006
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    Last Update Date     |    09/19/2013
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Provider Practice Location Address
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    Address Line         |    5656 BEE CAVE RD STE D204
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78746-5248
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    Country              |    US
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    Telephone            |    512-327-9251
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    Fax                  |    512-327-9742
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Provider Business Mailing Address
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    Address Line         |    5656 BEE CAVE RD STE D204
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78746-5248
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    Country              |    US
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    Telephone            |    512-327-9251
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    Fax                  |    512-327-9742
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    TX575
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    License Number State |    TX
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