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General NPI Number Information
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NPI Number | 1669986303
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Entity Type | Individual
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Provider Name | ALICIA VALDES GONZALEZ CSA
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Gender | Female
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 29310 PRAIRIE ROSE CT
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City | KATY
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State | TX
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Zip | 77494-7384
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Country | US
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Telephone | 786-556-8819
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 HAYES RD APT 6914
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City | HOUSTON
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State | TX
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Zip | 77077-6943
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Country | US
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Telephone | 979-330-8319
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 17363
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License Number State | TX
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