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General NPI Number Information
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NPI Number | 1124747878
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Entity Type | Individual
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Provider Name | JOSEPH DEAN VALEK CCP
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Gender | Male
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 3463 MAGIC DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-2973
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Country | US
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Telephone | 210-614-8101
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Fax |
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Provider Business Mailing Address
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Address Line | 3604 GILLESPIE RD
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City | MCKINNEY
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State | TX
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Zip | 75072-9021
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Country | US
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Telephone | 903-814-2999
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Fax |
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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 | 242T00000X
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Taxonomy Name | Perfusionist
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License Number | FPF00000267
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License Number State | TX
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