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General NPI Number Information
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NPI Number | 1811067374
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Entity Type | Individual
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Provider Name | ANNA VALLES P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 1741 E BARDIN RD
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City | ARLINGTON
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State | TX
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Zip | 76018-4836
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Country | US
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Telephone | 817-702-8700
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Fax | 817-702-4243
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Provider Business Mailing Address
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Address Line | 1350 S MAIN ST STE 3200
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City | FORT WORTH
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State | TX
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Zip | 76104-7669
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Country | US
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Telephone | 817-702-8400
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA05100
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License Number State | TX
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