MEDICARE: NORA I VALDES MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	K9444	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336351121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORA I VALDES MD PA

Provider Business Mailing Address
First Line	:	4903 GOLDEN QUAIL STE 114
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1585
Country	:	US
Telephone Number	:	210-614-0000
Fax Number	:	210-641-2441

Provider Business Practice Location Address
First Line	:	4903 GOLDEN QUAIL STE 114
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240
Country	:	US
Telephone Number	:	210-614-0000
Fax Number	:	210-641-2441

Authorized Official
Title or Position	:	OWNER
Name	:	NORA I VALDES
Credential	:	MD
Telephone Number	:	210-614-0000

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	05/16/2018

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